Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> Bacteremia
Carbapenems are antimicrobial agents commonly used to treat extended-spectrum β-lactamase (ESBL)-producing bacteria. Although cefmetazole (CMZ) is considered effective for ESBL-producing <i>Escherichia coli</i> (ESBL-EC) bacteremia, previous studies showed its limitations, including the...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Infectious Disease Reports |
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| Online Access: | https://www.mdpi.com/2036-7449/16/1/3 |
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| author | Takanobu Hoshi Satoshi Fujii Kei Watanabe Yuta Fukumura Koji Miyazaki Madoka Takahashi Sakae Taniguchi Shingo Kimura Arisa Saito Naoki Wada Masaji Saijo Kazunori Yamada Kuninori Iwayama Marie Itaya Hideki Sato |
| author_facet | Takanobu Hoshi Satoshi Fujii Kei Watanabe Yuta Fukumura Koji Miyazaki Madoka Takahashi Sakae Taniguchi Shingo Kimura Arisa Saito Naoki Wada Masaji Saijo Kazunori Yamada Kuninori Iwayama Marie Itaya Hideki Sato |
| author_sort | Takanobu Hoshi |
| collection | DOAJ |
| description | Carbapenems are antimicrobial agents commonly used to treat extended-spectrum β-lactamase (ESBL)-producing bacteria. Although cefmetazole (CMZ) is considered effective for ESBL-producing <i>Escherichia coli</i> (ESBL-EC) bacteremia, previous studies showed its limitations, including the influence of the initial antimicrobial agent. Here, we examined the effects of different approaches to antimicrobial therapy with CMZ and meropenem (MEPM) on the time to defervescence in ESBL-EC bacteremia. Notably, the influence of previous antimicrobial agents was excluded. Inpatients with ESBL-EC detected in blood cultures between April 2018 and March 2023 were included and assigned to CMZ (<i>n</i> = 14), MEPM (<i>n</i> = 8), de-escalation to CMZ (dCMZ; <i>n</i> = 9), or escalation to MEPM (eMEPM; <i>n</i> = 11) groups. The median time to defervescence was 3.5, 1.0, 2.0, and 4.0 days in the CMZ, MEPM, dCMZ, and eMEPM groups, respectively, with no significant differences. Cox proportional hazards analysis showed a significant difference in the hazard ratio (95% confidence interval) of 0.378 (0.145–0.984) for the time to defervescence with CMZ versus MEPM (<i>p</i> = 0.046). The extent of a delayed time to defervescence is greater with early CMZ administration than with MEPM administration in patients with non-severe ESBL-EC bacteremia. |
| first_indexed | 2024-03-07T22:29:58Z |
| format | Article |
| id | doaj.art-b77e075bbfc0457a880185be0652f62b |
| institution | Directory Open Access Journal |
| issn | 2036-7449 |
| language | English |
| last_indexed | 2024-03-07T22:29:58Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Infectious Disease Reports |
| spelling | doaj.art-b77e075bbfc0457a880185be0652f62b2024-02-23T15:19:03ZengMDPI AGInfectious Disease Reports2036-74492023-12-01161263410.3390/idr16010003Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> BacteremiaTakanobu Hoshi0Satoshi Fujii1Kei Watanabe2Yuta Fukumura3Koji Miyazaki4Madoka Takahashi5Sakae Taniguchi6Shingo Kimura7Arisa Saito8Naoki Wada9Masaji Saijo10Kazunori Yamada11Kuninori Iwayama12Marie Itaya13Hideki Sato14Division of Clinical Pharmacy, Department of Pharmacy, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo-shi 006-8585, Hokkaido, JapanDepartment of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo-shi 060-8543, Hokkaido, JapanDepartment of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDepartment of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDepartment of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDepartment of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDepartment of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDepartment of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDepartment of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDepartment of Clinical Laboratory, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDepartment of Primary Care, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDepartment of Pharmacy, Nakamura Memorial Hospital, Sapporo-shi 060-8570, Hokkaido, JapanDivision of Clinical Pharmacy, Department of Pharmacy, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo-shi 006-8585, Hokkaido, JapanDepartment of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, JapanDivision of Clinical Pharmacy, Department of Pharmacy, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo-shi 006-8585, Hokkaido, JapanCarbapenems are antimicrobial agents commonly used to treat extended-spectrum β-lactamase (ESBL)-producing bacteria. Although cefmetazole (CMZ) is considered effective for ESBL-producing <i>Escherichia coli</i> (ESBL-EC) bacteremia, previous studies showed its limitations, including the influence of the initial antimicrobial agent. Here, we examined the effects of different approaches to antimicrobial therapy with CMZ and meropenem (MEPM) on the time to defervescence in ESBL-EC bacteremia. Notably, the influence of previous antimicrobial agents was excluded. Inpatients with ESBL-EC detected in blood cultures between April 2018 and March 2023 were included and assigned to CMZ (<i>n</i> = 14), MEPM (<i>n</i> = 8), de-escalation to CMZ (dCMZ; <i>n</i> = 9), or escalation to MEPM (eMEPM; <i>n</i> = 11) groups. The median time to defervescence was 3.5, 1.0, 2.0, and 4.0 days in the CMZ, MEPM, dCMZ, and eMEPM groups, respectively, with no significant differences. Cox proportional hazards analysis showed a significant difference in the hazard ratio (95% confidence interval) of 0.378 (0.145–0.984) for the time to defervescence with CMZ versus MEPM (<i>p</i> = 0.046). The extent of a delayed time to defervescence is greater with early CMZ administration than with MEPM administration in patients with non-severe ESBL-EC bacteremia.https://www.mdpi.com/2036-7449/16/1/3cefmetazolemeropenemextended-spectrum β-lactamase<i>Escherichia coli</i> bacteremia |
| spellingShingle | Takanobu Hoshi Satoshi Fujii Kei Watanabe Yuta Fukumura Koji Miyazaki Madoka Takahashi Sakae Taniguchi Shingo Kimura Arisa Saito Naoki Wada Masaji Saijo Kazunori Yamada Kuninori Iwayama Marie Itaya Hideki Sato Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> Bacteremia Infectious Disease Reports cefmetazole meropenem extended-spectrum β-lactamase <i>Escherichia coli</i> bacteremia |
| title | Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> Bacteremia |
| title_full | Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> Bacteremia |
| title_fullStr | Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> Bacteremia |
| title_full_unstemmed | Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> Bacteremia |
| title_short | Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> Bacteremia |
| title_sort | effect of different approaches to antimicrobial therapy with cefmetazole and meropenem on the time to defervescence in non severe extended spectrum β lactamase producing i escherichia coli i bacteremia |
| topic | cefmetazole meropenem extended-spectrum β-lactamase <i>Escherichia coli</i> bacteremia |
| url | https://www.mdpi.com/2036-7449/16/1/3 |
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