{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Gutierrez-Gutierrez B"],"funding":["NIAID NIH HHS"],"pagination":["1672-80"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC4867097"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["71(6)"],"pubmed_abstract":["Data about the efficacy of ertapenem for the treatment of bloodstream infections (BSI) due to ESBL-producing Enterobacteriaceae (ESBL-E) are limited. We compared the clinical efficacy of ertapenem and other carbapenems in monomicrobial BSI due to ESBL-E.A multinational retrospective cohort study (INCREMENT project) was performed (ClinicalTrials.gov identifier: NCT01764490). Patients given monotherapy with ertapenem or other carbapenems were compared. Empirical and targeted therapies were analysed. Propensity scores were used to control for confounding; sensitivity analyses were performed in subgroups. The outcome variables were cure/improvement rate at day 14 and all-cause 30 day mortality.The empirical therapy cohort (ETC) and the targeted therapy cohort (TTC) included 195 and 509 patients, respectively. Cure/improvement rates were 90.6% with ertapenem and 75.5% with other carbapenems (P?=?0.06) in the ETC and 89.8% and 82.6% (P?=?0.02) in the TTC, respectively; 30 day mortality rates were 3.1% and 23.3% (P?=?0.01) in the ETC and 9.3% and 17.1% (P?=?0.01) in the TTC, respectively. Adjusted ORs (95% CI) for cure/improvement with empirical and targeted ertapenem were 1.87 (0.24-20.08; P?=?0.58) and 1.04 (0.44-2.50; P?=?0.92), respectively. For the propensity-matched cohorts it was 1.18 (0.43-3.29; P?=?0.74). Regarding 30 day mortality, the adjusted HR (95% CI) for targeted ertapenem was 0.93 (0.43-2.03; P?=?0.86) and for the propensity-matched cohorts it was 1.05 (0.46-2.44; P?=?0.90). Sensitivity analyses were consistent except for patients with severe sepsis/septic shock, which showed a non-significant trend favouring other carbapenems.Ertapenem appears as effective as other carbapenems for empirical and targeted therapy of BSI due to ESBL-E, but further studies are needed for patients with severe sepsis/septic shock."],"journal":["The Journal of antimicrobial chemotherapy"],"pubmed_title":["Ertapenem for the treatment of bloodstream infections due to ESBL-producing Enterobacteriaceae: a multinational pre-registered cohort study."],"pmcid":["PMC4867097"],"funding_grant_id":["R01AI072219","R01AI063517"],"pubmed_authors":["Pintado V","Oliver A","Gonzalez V","Machuca I","Calbo E","Francisco CN","Tacconelli E","Molina J","Almela M","Galvez J","Ruiz P","Prim N","Farinas MC","Hamprecht A","Cano ME","Hsueh PR","Antoniadou A","Bou G","Azap OK","Virmani D","Russo A","Hernandez A","Gozalo M","Tuon FF","Roilides E","Akova M","Doi Y","Falcone M","Karaiskos I","Rodriguez-Bano J","Pascual A","Venditti M","Tsakris A","Riemenschneider F","Garcia-Vazquez E","Badia C","Juan RS","Bermejo J","Lowman W","Almirante B","Martinez-Martinez L","Fontanals D","Perez-Nadales E","Sahin AO","Carmeli Y","Torre-Cisneros J","Pano-Pardo JR","Pitout J","de Gopegui ER","Pournaras S","Gracia-Ahulfinger I","Giannella M","Schwaber MJ","Souli M","Puig M","Viale P","Cisneros JM","Perez F","Navarro F","Mirelis B","Daikos G","Gomez-Zorrilla S","Fernandez-Ruiz M","de Cueto M","Tumbarello M","Jove E","Canton R","REIPI/ESGBIS/INCREMENT Group","Poulakou G","Mora-Rillo M","Pena C","Bonomo RA","Gasch O","Salamanca E","Giamarellou H","Bartoletti M","Gomez J","Xercavins M","Paterson DL","Origuen J","Gutierrez-Gutierrez B","Larrosa N","Trecarichi EM","Iosifidis E","Helvaci O","Marinescu CI","Rucci V","Zarkotou O","Tubau F","Losito AR"],"additional_accession":[]},"is_claimable":false,"name":"Ertapenem for the treatment of bloodstream infections due to ESBL-producing Enterobacteriaceae: a multinational pre-registered cohort study.","description":"Data about the efficacy of ertapenem for the treatment of bloodstream infections (BSI) due to ESBL-producing Enterobacteriaceae (ESBL-E) are limited. We compared the clinical efficacy of ertapenem and other carbapenems in monomicrobial BSI due to ESBL-E.A multinational retrospective cohort study (INCREMENT project) was performed (ClinicalTrials.gov identifier: NCT01764490). Patients given monotherapy with ertapenem or other carbapenems were compared. Empirical and targeted therapies were analysed. Propensity scores were used to control for confounding; sensitivity analyses were performed in subgroups. The outcome variables were cure/improvement rate at day 14 and all-cause 30 day mortality.The empirical therapy cohort (ETC) and the targeted therapy cohort (TTC) included 195 and 509 patients, respectively. Cure/improvement rates were 90.6% with ertapenem and 75.5% with other carbapenems (P?=?0.06) in the ETC and 89.8% and 82.6% (P?=?0.02) in the TTC, respectively; 30 day mortality rates were 3.1% and 23.3% (P?=?0.01) in the ETC and 9.3% and 17.1% (P?=?0.01) in the TTC, respectively. Adjusted ORs (95% CI) for cure/improvement with empirical and targeted ertapenem were 1.87 (0.24-20.08; P?=?0.58) and 1.04 (0.44-2.50; P?=?0.92), respectively. For the propensity-matched cohorts it was 1.18 (0.43-3.29; P?=?0.74). Regarding 30 day mortality, the adjusted HR (95% CI) for targeted ertapenem was 0.93 (0.43-2.03; P?=?0.86) and for the propensity-matched cohorts it was 1.05 (0.46-2.44; P?=?0.90). Sensitivity analyses were consistent except for patients with severe sepsis/septic shock, which showed a non-significant trend favouring other carbapenems.Ertapenem appears as effective as other carbapenems for empirical and targeted therapy of BSI due to ESBL-E, but further studies are needed for patients with severe sepsis/septic shock.","dates":{"release":"2016-01-01T00:00:00Z","publication":"2016 Jun","modification":"2021-02-20T06:24:42Z","creation":"2019-03-27T02:13:39Z"},"accession":"S-EPMC4867097","cross_references":{"pubmed":["26907184"],"doi":["10.1093/jac/dkv502"]}}