In-hospital mortality was similar for use of cefepime and carbapenems in adjusted regression models and propensity-score matched analyses.Ĭefepime has a similar efficacy as carbapenems for the treatment of Enterobacter species bacteremia. 39), and a nonsignificant lower odds ratio with cefepime use (aOR, 0.52 95% CI. In multivariable models, there was no association between carbapenem use and persistent bacteremia (adjusted odds ratio, 1.52 95% CI. None of the 36 patients who received single-agent cefepime (0%) had persistent bacteremia, as opposed to 4 of 16 (25%) of those who received single-agent carbapenem (P <. Twenty-nine (11%) patients had persistent bacteremia for ≥1 day after antibacterial initiation. Median age was 59 years 19% were neutropenic, and 22% were in an intensive care unit on the day of bacteremia. Three hundred sixty-eight patients experienced Enterobacter species bacteremia and received at least 1 antimicrobial agent, of whom 52 (14%) died during hospitalization. We fit logistic regression models, adjusting for clinical risk factors and Pitt bacteremia score and performed propensity score analyses to compare the efficacy of cefepime and carbapenems. Outcomes of interest were (1) persistent bacteremia ≥1 calendar day and (2) in-hospital mortality. We reviewed all cases of Enterobacter species bacteremia at 2 academic hospitals from 2005 to 2011. Although isolates are typically susceptible to cefepime in vitro, there are few data supporting its clinical efficacy. Carbapenems are recommended for treatment of Enterobacter infections with AmpC phenotypes.
0 kommentar(er)
