{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Palacios-Baena ZR"],"funding":["National Institute of Allergy and Infectious Diseases","NIAID NIH HHS","National Institutes of Health"],"pagination":["1615-1623"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC5849995"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["65(10)"],"pubmed_abstract":["<h4>Background</h4>There is little information about the efficacy of active alternative drugs to carbapenems except β-lactam/β-lactamase inhibitors for the treatment of bloodstream infections (BSIs) due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). The objective of this study was to assess the outcomes of patients with BSI due to ESBL-E who received empiric therapy with such drugs (other active drugs [OADs]) or carbapenems.<h4>Methods</h4>A multinational retrospective cohort study of patients with BSI due to ESBL-E who received empiric treatment with OADs or carbapenems was performed. Cox regression including a propensity score for receiving OADs was performed to analyze 30-day all-cause mortality as main outcome. Clinical failure and length of stay were also analyzed.<h4>Results</h4>Overall, 335 patients were included; 249 received empiric carbapenems and 86 OADs. The most frequent OADs were aminoglycosides (43 patients) and fluoroquinolones (20 patients). Empiric therapy with OADs was not associated with mortality (hazard ratio [HR], 0.75; 95% confidence interval [CI], .38-1.48) in the Cox regression analysis. Propensity score-matched pairs, subgroups, and sensitivity analyses did not show different trends; specifically, the adjusted HR for aminoglycosides was 1.05 (95% CI, .51-2.16). OADs were neither associated with 14-day clinical failure (adjusted odds ratio, 0.62; 95% CI, .29-1.36) nor length of hospital stay.<h4>Conclusions</h4>We were unable to show that empiric treatment with OAD was associated with a worse outcome compared with carbapenems. This information allows more options to be considered for empiric therapy, at least for some patients, depending on local susceptibility patterns of ESBL-E."],"journal":["Clinical infectious diseases : an official publication of the Infectious Diseases Society of America"],"pubmed_title":["Empiric Therapy With Carbapenem-Sparing Regimens for Bloodstream Infections due to Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: Results From the INCREMENT Cohort."],"pmcid":["PMC5849995"],"funding_grant_id":["R01 AI063517","R01AI072219 and R01AI063517","R01 AI072219"],"pubmed_authors":["Pintado V","Ruiz-Garbajosa P","Oliver A","Gonzalez V","Machuca I","Calbo E","Tacconelli E","de la Calle C","Molina J","Almela M","Galvez J","Molina Gil-Bermejo J","Prim N","Farinas MC","Hamprecht A","Cano ME","Hsueh PR","Antoniadou A","Bou G","Azap OK","Virmani D","Hernandez A","Russo A","Gozalo M","Tuon FF","Roilides E","Akova M","Doi Y","Falcone M","Karaiskos I","Rodriguez-Bano J","Pascual A","Venditti M","Tsakris A","Badia C","Bermejo J","Ruiz de Gopegui E","Palacios-Baena ZR","Lowman W","Almirante B","Martinez-Martinez L","Fontanals D","Sahin AO","Carmeli Y","San Juan R","Peter S","Torre-Cisneros J","Pano-Pardo JR","Pitout J","Pournaras S","Martinez JA","Giannella M","Schwaber MJ","Souli M","Puig M","Viale P","Perez F","Navarro F","Mirelis B","Daikos G","Gomez-Zorrilla S","Fernandez-Ruiz M","Tumbarello M","Jove E","Poulakou G","Morata L","Mora-Rillo M","Pena C","Gasch O","Bonomo RA","Giamarellou H","Bartoletti M","Gomez J","Xercavins M","Paterson DL","Gutierrez-Gutierrez B","Larrosa N","Trecarichi EM","Iosifidis E","Helvaci O","Marinescu CI","Rucci V","Zarkotou O","Spanish Network for Research in Infectious Diseases","Tubau F","Losito AR","Cano A"],"additional_accession":[]},"is_claimable":false,"name":"Empiric Therapy With Carbapenem-Sparing Regimens for Bloodstream Infections due to Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: Results From the INCREMENT Cohort.","description":"<h4>Background</h4>There is little information about the efficacy of active alternative drugs to carbapenems except β-lactam/β-lactamase inhibitors for the treatment of bloodstream infections (BSIs) due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). The objective of this study was to assess the outcomes of patients with BSI due to ESBL-E who received empiric therapy with such drugs (other active drugs [OADs]) or carbapenems.<h4>Methods</h4>A multinational retrospective cohort study of patients with BSI due to ESBL-E who received empiric treatment with OADs or carbapenems was performed. Cox regression including a propensity score for receiving OADs was performed to analyze 30-day all-cause mortality as main outcome. Clinical failure and length of stay were also analyzed.<h4>Results</h4>Overall, 335 patients were included; 249 received empiric carbapenems and 86 OADs. The most frequent OADs were aminoglycosides (43 patients) and fluoroquinolones (20 patients). Empiric therapy with OADs was not associated with mortality (hazard ratio [HR], 0.75; 95% confidence interval [CI], .38-1.48) in the Cox regression analysis. Propensity score-matched pairs, subgroups, and sensitivity analyses did not show different trends; specifically, the adjusted HR for aminoglycosides was 1.05 (95% CI, .51-2.16). OADs were neither associated with 14-day clinical failure (adjusted odds ratio, 0.62; 95% CI, .29-1.36) nor length of hospital stay.<h4>Conclusions</h4>We were unable to show that empiric treatment with OAD was associated with a worse outcome compared with carbapenems. This information allows more options to be considered for empiric therapy, at least for some patients, depending on local susceptibility patterns of ESBL-E.","dates":{"release":"2017-01-01T00:00:00Z","publication":"2017 Oct","modification":"2026-05-02T06:49:26.274Z","creation":"2026-04-07T17:42:11.477Z"},"accession":"S-EPMC5849995","cross_references":{"pubmed":["29020250"],"doi":["10.1093/cid/cix606"]}}