Efficacy of β-Lactam/β-Lactamase Inhibitor Combinations for the Treatment of Bloodstream Infection Due to Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in Hematological Patients with Neutropenia

• Published in: Antimicrobial agents and chemotherapy Vol. 61; no. 8
• Main Authors: Gudiol, Carlota, Royo-Cebrecos, Cristina, Abdala, Edson, Akova, Murat, Álvarez, Rocío, Maestro-de la Calle, Guillermo, Cano, Angela, Cervera, Carlos, Clemente, Wanessa T, Martín-Dávila, Pilar, Freifeld, Alison, Gómez, Lucía, Gottlieb, Thomas, Gurguí, Mercè, Herrera, Fabián, Manzur, Adriana, Maschmeyer, Georg, Meije, Yolanda, Montejo, Miguel, Peghin, Maddalena, Rodríguez-Baño, Jesús, Ruiz-Camps, Isabel, Sukiennik, Teresa C, Tebe, Cristian, Carratalà, Jordi
• Format: Journal Article
• Language: English
• Published: United States American Society for Microbiology 01.08.2017
• Subjects: Adult; Anti-Bacterial Agents; Anti-Bacterial Agents - therapeutic use; Bacteremia; Bacteremia - complications; Bacteremia - drug therapy; Bacteremia - microbiology; Bacteremia - mortality; beta-Lactamase Inhibitors; beta-Lactamase Inhibitors - therapeutic use; beta-Lactamases - metabolism; beta-Lactams - therapeutic use; Carbapenems - therapeutic use; Clinical Therapeutics; Cohort Studies; Enterobacteriaceae; Enterobacteriaceae - drug effects; Enterobacteriaceae - enzymology; Enterobacteriaceae Infections; Enterobacteriaceae Infections - complications; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - microbiology; Enterobacteriaceae Infections - mortality; Female; Humans; Male; Middle Aged; Neutropenia; Neutropenia - complications; ESBLs; mortality; neutropenia; bloodstream infection; beta-lactam/beta-lactamase inhibitors
• ISSN: 0066-4804; 1098-6596
• DOI: 10.1128/AAC.00164-17

β-Lactam/β-lactamase inhibitors (BLBLIs) were compared to carbapenems in two cohorts of hematological neutropenic patients with extended-spectrum-β-lactamase (ESBL) bloodstream infection (BSI): the empirical therapy cohort (174 patients) and the definitive therapy cohort (251 patients). The 30-day case fatality rates and other secondary outcomes were similar in the two therapy groups of the two cohorts and also in the propensity-matched cohorts. BLBLIs might be carbapenem-sparing alternatives for the treatment of BSI due to ESBLs in these patients.