Beta-Lactam/Beta-Lactamase Inhibitor Therapy for Potential AmpC-Producing Organisms: A Systematic Review and Meta-Analysis

Matthew P Cheng; Robyn S Lee; Alexandre P Cheng; Samuel De L'étoile-Morel; Koray Demir; Cedric P Yansouni; Patrick Harris; Emily G Mcdonald; Todd C Lee

doi:10.1093/ofid/ofz248

Beta-Lactam/Beta-Lactamase Inhibitor Therapy for Potential AmpC-Producing Organisms: A Systematic Review and Meta-Analysis

Open Forum Infect Dis. 2019 Jul 1;6(7):ofz248. doi: 10.1093/ofid/ofz248.

Authors

Matthew P Cheng¹, Robyn S Lee², Alexandre P Cheng³, Samuel De L'étoile-Morel⁴, Koray Demir⁵, Cedric P Yansouni⁴, Patrick Harris^{6

7}, Emily G Mcdonald⁵, Todd C Lee^{4

5}

Affiliations

¹ Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
² Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
³ Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York.
⁴ Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Canada.
⁵ Clinical Practice Assessment Unit, Department of Medicine, McGill University Health Centre, Montreal, Canada.
⁶ University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia.
⁷ Department of Microbiology, Pathology Queensland, Central Laboratory, Royal Brisbane & Women's Hospital, Australia.

Abstract

The optimal treatment for potential AmpC-producing Enterobacteriaceae, including Serratia, Providencia, Citrobacter, Enterobacter, and Morganella species, remains unknown. An updated systematic review and meta-analysis of studies comparing beta-lactam/beta-lactamase inhibitors with carbapenems in the treatment of bloodstream infections with these pathogens found no significant difference in 30-day mortality (OR, 1.13; 95% CI, 0.58 - 2.20).

Keywords: ampC; Beta-Lactam; bacteremia; beta-lactamase; carbapenem.