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On January 18, 2010, a part of the capital region of Denmark shifted the empirical treatment of febrile conditions from cefuroxime to piperacillin/tazobactam. We compare empirical treatment with piperacillin/tazobactam versus cefuroxime for  bacteremia with regard to 14 days mortality, in a low prevalence cohort of Extended-spectrum beta-lactamase-producing .  From January 18, 2010 to December 31, 2012, we conducted a retrospective cohort study including patients with  bacteremia from six university hospitals in Copenhagen, Denmark. Clinical and laboratory information was obtained from a bacteremia research database, including information on comorbidity, and we used Cox proportional hazard analysis to asses all-cause 14 days mortality.  A total of 568 patients receiving either cefuroxime (n=377) or piperacillin/tazobactam (n=191) as empirical therapy were included. In the Cox proportional hazard model, cefuroxime treatment was significantly associated with death (mortality rate ratio 3.95, CI 1.12-13.90). Other variables associated with death were health care related infection (MRR 3.20, CI 1.67-6.15), hospital-acquired infection (MRR 2,17, CI 1.02-4.62), admission at intensive care unit (MRR 20.45, 5.31-78.82), and combination therapy with ciprofloxacin (MRR 2.14, CI 0.98-4.68).  Empiric cefuroxime treatment of  bacteremia was significantly associated with higher 14 days mortality in comparison with piperacillin/tazobactam.

infection and drug resistance

&lt;p&gt;Cefuroxime compared to piperacillin/tazobactam as empirical treatment of &lt;em&gt;Escherichia coli&lt;/em&gt; bacteremia in a low Extended-spectrum beta-lactamase (ESBL) prevalence cohort&lt;/p&gt;