Comparative effectiveness of flomoxef versus carbapenems in the treatment of bacteraemia due to extended-spectrum β-lactamase-producing Escherichia coli or Klebsiella pneumoniae with emphasis on minimum inhibitory concentration of flomoxef: a retrospective study
Comparative effectiveness of flomoxef versus carbapenems in the treatment of bacteraemia due to extended-spectrum β-lactamase-producing Escherichia coli or Klebsiella pneumoniae with emphasis on minimum inhibitory concentration of flomoxef: a retrospective study
复制标题
DOI：
10.1016/j.ijantimicag.2015.07.020
复制
发表时间：
2015-12-01
影响因子：
10.8
通讯作者：
Liu, Jien-Wei
中科院分区：
文献类型：
--
作者：
Lee, Chen-Hsiang;Su, Lin-Hui;Liu, Jien-Wei
该研究比较了因广谱p-内酰胺酶产生的大肠杆菌或肺炎克雷伯菌（ESBL-EK）引起的菌血症的成年患者接受氟莫昔夫和接受碳青霉烯类药物作为最终治疗的治疗结果。在倾向评分匹配（PSM）分析中，接受氟莫昔夫的患者与接受碳青霉烯类药物的对照组相匹配。主要终点为30天粗死亡率。氟莫昔组败血症相关死亡率（27.3% vs. 10.5%）和30天死亡率（28.8% vs. 12.8%）均显著高于碳青霉烯组。MICflomoxef = 4的分离株引起的菌血症发作与30天死亡率独立相关。氟莫昔治疗在治疗ESBL-EK菌血症方面似乎不如碳青霉烯类药物，特别是对于micrormo昔为2- 8mg /L的分离株，尽管目前建议的micrormo昔断点是
This study compared treatment outcomes of adult patients with bacteraemia due to extended-spectrum p-lactamase-producing Escherichia coli or Klebsiella pneumoniae (ESBL-EK) receiving flomoxef versus those receiving a carbapenem as definitive therapy. In propensity score matching (PSM) analysis, case patients receiving flomoxef shown to be active in vitro against ESBL-EK were matched with controls who received a carbapenem. The primary endpoint was 30-day crude mortality. The flomoxef group had statistically significantly higher sepsis-related mortality (27.3% vs. 10.5%) and 30-day mortality (28.8% vs. 12.8%) than the carbapenem group. Of the bacteraemic episodes caused by isolates with a MICflomoxef of = 4 were independently associated with 30-day mortality. Definitive flomoxef therapy appears to be inferior to carbapenems in treating ESBL-EK bacteraemia, particularly for isolates with a MICflomoxef of 2-8 mg/L, even though the currently suggested MIC breakpoint of flomoxef is