dc.creator | Pascual Hernández, Álvaro | es |
dc.creator | Rodríguez-Baño, Jesús | es |
dc.creator | Martínez Martínez, Luis | es |
dc.creator | Cueto López, Marina de | es |
dc.date.accessioned | 2017-08-29T12:46:58Z | |
dc.date.available | 2017-08-29T12:46:58Z | |
dc.date.issued | 2016-07-01 | |
dc.identifier.citation | Pascual Hernández, Á., Rodríguez Baño, J., Martínez Martínez, L. y Cueto López, M. (2016). A multinational, preregistered cohort study of β-lactam/β-lactamase inhibitor combinations for treatment of bloodstream infections due to extended-spectrum-β-lactamase-producing enterobacteriaceae. Antimicrobial Agents and Chemotherapy, 60 (7), 4159-4169. | |
dc.identifier.issn | 0066-4804 (impreso) | es |
dc.identifier.issn | 1098-6596 (electrónico) | es |
dc.identifier.uri | http://hdl.handle.net/11441/64065 | |
dc.description.abstract | The spread of extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) is leading to increased carbapenem consumption. Alternatives to carbapenems need to be investigated. We investigated whether β-lactam/β-lactamase inhibitor (BLBLI) combinations are as effective as carbapenems in the treatment of bloodstream infections (BSI) due to ESBL-E. A multinational, retrospective cohort study was performed. Patients with monomicrobial BSI due to ESBL-E were studied; specific criteria were applied for inclusion of patients in the empirical-therapy (ET) cohort (ETC; 365 patients), targeted-therapy (TT) cohort (TTC; 601 patients), and global cohort (GC; 627 patients). The main outcome variables were cure/improvement rate at day 14 and all-cause 30-day mortality. Multivariate analysis, propensity scores (PS), and sensitivity analyses were used to control for confounding. The cure/improvement rates with BLBLIs and carbapenems were 80.0% and 78.9% in the ETC and 90.2% and 85.5% in the TTC, respectively. The 30-day mortality rates were 17.6% and 20% in the ETC and 9.8% and 13.9% in the TTC, respectively. The adjusted odds ratio (OR) (95% confidence interval [CI]) values for cure/improvement rate with ET with BLBLIs were 1.37 (0.69 to 2.76); for TT, they were 1.61 (0.58 to 4.86). Regarding 30-day mortality, the adjusted OR (95% CI) values were 0.55 (0.25 to 1.18) for ET and 0.59 (0.19 to 1.71) for TT. The results were consistent in all subgroups studied, in a stratified analysis according to quartiles of PS, in PS-matched cases, and in the GC. BLBLIs, if active in vitro, appear to be as effective as carbapenems for ET and TT of BSI due to ESLB-E regardless of the source and specific species. These data may help to avoid the overuse of carbapenems. | es |
dc.description.sponsorship | Unión Euroea y EFPIA FP7/2007-2013 | es |
dc.format | application/pdf | es |
dc.language.iso | eng | es |
dc.publisher | American Society for Microbiology | es |
dc.relation.ispartof | Antimicrobial Agents and Chemotherapy, 60 (7), 4159-4169. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.title | A multinational, preregistered cohort study of β-lactam/β-lactamase inhibitor combinations for treatment of bloodstream infections due to extended-spectrum-β-lactamase-producing enterobacteriaceae | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Microbiología | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina | es |
dc.relation.projectID | FP7/2007-2013 | es |
dc.relation.publisherversion | http://dx.doi.org/10.1128/AAC.00365-16 | es |
dc.identifier.doi | 10.1128/AAC.00365-16 | es |
idus.format.extent | 11 p. | es |
dc.journaltitle | Antimicrobial Agents and Chemotherapy | es |
dc.publication.volumen | 60 | es |
dc.publication.issue | 7 | es |
dc.publication.initialPage | 4159 | es |
dc.publication.endPage | 4169 | es |
dc.contributor.funder | European Union (UE). FP7 | |