Ertapenem for treatment of extended-spectrum beta-lactamase-producing and multidrug-resistant gram-negative bacteraemia.
- Author:
David Chien LYE
1
;
Limin WIJAYA
;
Joey CHAN
;
Chew Ping TENG
;
Yee Sin LEO
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; pharmacology; therapeutic use; Bacteremia; drug therapy; etiology; Drug Resistance, Multiple, Bacterial; Escherichia coli; drug effects; enzymology; Escherichia coli Infections; drug therapy; microbiology; Female; Gram-Negative Bacteria; drug effects; enzymology; Gram-Negative Bacterial Infections; drug therapy; microbiology; Humans; Klebsiella Infections; drug therapy; microbiology; Klebsiella pneumoniae; drug effects; enzymology; Male; Microbial Sensitivity Tests; Middle Aged; Retrospective Studies; Urinary Tract Infections; complications; drug therapy; beta-Lactamases; biosynthesis; beta-Lactams; pharmacology; therapeutic use
- From:Annals of the Academy of Medicine, Singapore 2008;37(10):831-834
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONImipenem and meropenem are treatment of choice for extended-spectrum betalactamase (ESBL)-positive gram-negative bacteraemia. They may select for carbapenemresistant Acinetobacter baumannii and Pseudomonas aeruginosa; ertapenem may not do so as it is inactive against these bacteria. Clinical efficacy of ertapenem in ESBL-producing gramnegative bacteraemia is limited.
MATERIALS AND METHODSRetrospective study of patients with ESBL-positive gram-negative bacteraemia treated with ertapenem was undertaken.
RESULTSForty-seven patients with multidrug-resistant gram-negative bacteraemia (79% produced ESBL) were treated with ertapenem for a median duration of 11 days. The median age was 70 years. Septic shock occurred in 19% and mechanical ventilation was needed in 17%. Klebsiella pneumoniae comprised 53% and Escherichia coli 26%. Urinary infection accounted for 61% and hepatobiliary 15%. Favourable clinical response occurred in 96%. Attributable mortality was 4%.
CONCLUSIONErtapenem is promising in culture-guided step-down therapy of ESBL-positive gram-negative bacteraemia.
