Efficacy of β-Lactam/β-Lactamase Inhibitor Combinations for the Treatment of Bloodstream Infection Due to Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in Hematological Patients with Neutropenia

Antimicrob Agents Chemother. 2017 Jul 25;61(8):e00164-17. doi: 10.1128/AAC.00164-17. Print 2017 Aug.

Abstract

β-Lactam/β-lactamase inhibitors (BLBLIs) were compared to carbapenems in two cohorts of hematological neutropenic patients with extended-spectrum-β-lactamase (ESBL) bloodstream infection (BSI): the empirical therapy cohort (174 patients) and the definitive therapy cohort (251 patients). The 30-day case fatality rates and other secondary outcomes were similar in the two therapy groups of the two cohorts and also in the propensity-matched cohorts. BLBLIs might be carbapenem-sparing alternatives for the treatment of BSI due to ESBLs in these patients.

Keywords: ESBLs; beta-lactam/beta-lactamase inhibitors; bloodstream infection; mortality; neutropenia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / complications
  • Bacteremia / drug therapy*
  • Bacteremia / microbiology
  • Bacteremia / mortality
  • Carbapenems / therapeutic use
  • Cohort Studies
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / enzymology
  • Enterobacteriaceae Infections / complications
  • Enterobacteriaceae Infections / drug therapy*
  • Enterobacteriaceae Infections / microbiology
  • Enterobacteriaceae Infections / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neutropenia / complications*
  • beta-Lactamase Inhibitors / therapeutic use*
  • beta-Lactamases / metabolism
  • beta-Lactams / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • beta-Lactamase Inhibitors
  • beta-Lactams
  • beta-Lactamases