Cefepime Therapy for Cefepime-Susceptible Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Bacteremia | Zendy

Ruibin Wang | Zendy; Sara E. Cosgrove | Zendy; Sarah TschudinSutter | Zendy; Jennifer Han | Zendy; Alison E. Turnbull | Zendy; Alice J. Hsu | Zendy; Edina Avdic | Zendy; Karen C. Carroll | Zendy; Pranita D. Tamma | Zendy

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Cefepime Therapy for Cefepime-Susceptible Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Bacteremia

Author(s) -

Ruibin Wang,

Sara E. Cosgrove,

Sarah TschudinSutter,

Jennifer Han,

Alison E. Turnbull,

Alice J. Hsu,

Edina Avdic,

Karen C. Carroll,

Pranita D. Tamma

Publication year - 2016

Publication title -

open forum infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.546

H-Index - 35

ISSN - 2328-8957

DOI - 10.1093/ofid/ofw132

Subject(s) - cefepime , bacteremia , medicine , carbapenem , hazard ratio , confidence interval , cephalosporin , intensive care medicine , antibiotics , microbiology and biotechnology , antibiotic resistance , imipenem , biology

The role of cefepime for extended-spectrum β-lactamase (ESBL) bacteremia is unclear if susceptible in vitro. In a propensity score-matched study of patients with ESBL bacteremia, risk of death was 2.87 times higher for patients receiving cefepime compared with carbapenems (95% confidence interval [CI], .88-9.41). We compared 14-day mortality of patients with ESBL bacteremia receiving empiric cefepime versus empiric carbapenem therapy in a propensity score-matched cohort. There was a trend towards increased mortality in the cefepime group (hazard ratio, 2.87; 95% CI, .88-9.41), which enhances the existing literature suggesting that cefepime may be suboptimal for invasive ESBL infections.

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