Portal de investigación
Clinical impact of ertapenem de-escalation in critically-ill patients with Enterobacteriaceae infections
Fecha de publicación:
Autores organización
Autores
- Cuesta, DP
- Blanco, VM
- Vallejo, ME
- Hernández-Gómez, C
- Maya, JJ
- Motoa, G
- Correa, A
- Matta, L
- Rosso, F
- Camargo, RD
- Muñoz, M
- Florez, E
- Nagles, J
- Ovalle, A
- Reyes, S
Grupos de investigación
Resumen
Background: Ertapenem has proven to be effective for extended-spectrum beta-lactamases-producing Enterobacteriaceae but lacks activity against non-fermenters; de-escalation to this antibiotic may reduce the selection of resistance to Pseudomonas aeruginosa and improve clinical outcomes. Aim: To evaluate the clinical impact of de-escalation from broad-spectrum anti-pseudomonal agents to ertapenem, a non-pseudomonal antibiotics for Enterobacteriaceae infections in critically-ill patients. Methods: We conducted a prospective cohort study in adult patients admitted to intensive care units (ICUs) who had Enterobacteriaceae infections and were deescalated from empiric anti-pseudomonal coverage to non-pseudomonal antibiotics. Cox proportional hazards models were performed comparing all-cause mortality and length of hospital stay between patients who remained on anti-pseudomonal coverage versus those who were de-escalated to ertapenem. Results: 105 patients in the anti-pseudomonal group were compared to 148 patients in the ertapenem de-escalation group. De-escalation was associated with lower all-cause mortality compared to patients who remained on anti-pseudomonal coverage (adjusted Hazard Ratio 0.24; 95% CI: 0.12-0.46). The length of ICU stay was similar between the groups. Discussion: ICU patients with Enterobacteriaceae infections de-escalated to ertapenem therapy had better outcomes compared to patients who remained on broad-spectrum, anti-pseudomonal therapy, suggesting that de-escalation is a safe approach amongst ICU patients.
Datos de la publicación
- ISSN/ISSNe:
- 0716-1018, 0717-6341
- Tipo:
- Article
- Páginas:
- 9-15
Revista Chilena De Infectologia SOC CHILENA INFECTOLOGIA
Citas Recibidas en Web of Science: 2
Citas Recibidas en Scopus: 3
Documentos
- No hay documentos
Filiaciones
Keywords
- Intensive care unit; Enterobacteriaceae Infections; ertapenem; de-escalation; mortality
Proyectos asociados
El rol del clon ST131 en la diseminación, multidrogorresistencia y mayor virulencia de aislamientos clínicos de Escherichia coli portador de Beta-lactamasas de Espectro Extendido asociado con infecciones procedentes de instituciones hospitalarias y de la comunidad.
Investigador Principal: MARIA VIRGINIA VILLEGAS BOTERO
PCI-2017-9453 . 2018
Citar la publicación
Cuesta DP,Blanco VM,Vallejo ME,Hernández C,Maya JJ,Motoa G,Correa A,Matta L,Rosso F,Camargo RD,Muñoz M,Florez E,Nagles J,Ovalle A,Reyes S,Villegas MV. Clinical impact of ertapenem de-escalation in critically-ill patients with <i>Enterobacteriaceae</i> infections. Rev Chilena Infectol. 2019. 36. (1):p. 9-15. IF:0,520. (4).