A targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP)
Cefepime and piperacillin/tazobactam are antimicrobials recommended by IDSA/ATS guidelines for the empirical management of patients admitted to the intensive care unit (ICU) with community-acquired pneumonia (CAP). Concerns have been raised about which should be used in clinical practice. This study...
| Автори: | , , , , , , , , |
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| Формат: | Journal article |
| Мова: | English |
| Опубліковано: |
Nature Research
2024
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| _version_ | 1826313218145910784 |
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| author | Serrano-Mayorga, CC Duque, S Ibáñez-Prada, ED Garcia-Gallo, E Arrieta, MPR Bastidas, A Rodríguez, A Martin-Loeches, I Reyes, LF |
| author_facet | Serrano-Mayorga, CC Duque, S Ibáñez-Prada, ED Garcia-Gallo, E Arrieta, MPR Bastidas, A Rodríguez, A Martin-Loeches, I Reyes, LF |
| author_sort | Serrano-Mayorga, CC |
| collection | OXFORD |
| description | Cefepime and piperacillin/tazobactam are antimicrobials recommended by IDSA/ATS guidelines for the empirical management of patients admitted to the intensive care unit (ICU) with community-acquired pneumonia (CAP). Concerns have been raised about which should be used in clinical practice. This study aims to compare the effect of cefepime and piperacillin/tazobactam in critically ill CAP patients through a targeted maximum likelihood estimation (TMLE). A total of 2026 ICU-admitted patients with CAP were included. Among them, (47%) presented respiratory failure, and (27%) developed septic shock. A total of (68%) received cefepime and (32%) piperacillin/tazobactam-based treatment. After running the TMLE, we found that cefepime and piperacillin/tazobactam-based treatments have comparable 28-day, hospital, and ICU mortality. Additionally, age, PTT, serum potassium and temperature were associated with preferring cefepime over piperacillin/tazobactam (OR 1.14 95% CI [1.01–1.27], p = 0.03), (OR 1.14 95% CI [1.03–1.26], p = 0.009), (OR 1.1 95% CI [1.01–1.22], p = 0.039) and (OR 1.13 95% CI [1.03–1.24], p = 0.014)]. Our study found a similar mortality rate among ICU-admitted CAP patients treated with cefepime and piperacillin/tazobactam. Clinicians may consider factors such as availability and safety profiles when making treatment decisions. |
| first_indexed | 2024-09-25T04:09:38Z |
| format | Journal article |
| id | oxford-uuid:df3be3f9-2094-4f5b-bcad-c991445960cd |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:09:38Z |
| publishDate | 2024 |
| publisher | Nature Research |
| record_format | dspace |
| spelling | oxford-uuid:df3be3f9-2094-4f5b-bcad-c991445960cd2024-06-11T20:10:50ZA targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP)Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:df3be3f9-2094-4f5b-bcad-c991445960cdEnglishJisc Publications RouterNature Research2024Serrano-Mayorga, CCDuque, SIbáñez-Prada, EDGarcia-Gallo, EArrieta, MPRBastidas, ARodríguez, AMartin-Loeches, IReyes, LFCefepime and piperacillin/tazobactam are antimicrobials recommended by IDSA/ATS guidelines for the empirical management of patients admitted to the intensive care unit (ICU) with community-acquired pneumonia (CAP). Concerns have been raised about which should be used in clinical practice. This study aims to compare the effect of cefepime and piperacillin/tazobactam in critically ill CAP patients through a targeted maximum likelihood estimation (TMLE). A total of 2026 ICU-admitted patients with CAP were included. Among them, (47%) presented respiratory failure, and (27%) developed septic shock. A total of (68%) received cefepime and (32%) piperacillin/tazobactam-based treatment. After running the TMLE, we found that cefepime and piperacillin/tazobactam-based treatments have comparable 28-day, hospital, and ICU mortality. Additionally, age, PTT, serum potassium and temperature were associated with preferring cefepime over piperacillin/tazobactam (OR 1.14 95% CI [1.01–1.27], p = 0.03), (OR 1.14 95% CI [1.03–1.26], p = 0.009), (OR 1.1 95% CI [1.01–1.22], p = 0.039) and (OR 1.13 95% CI [1.03–1.24], p = 0.014)]. Our study found a similar mortality rate among ICU-admitted CAP patients treated with cefepime and piperacillin/tazobactam. Clinicians may consider factors such as availability and safety profiles when making treatment decisions. |
| spellingShingle | Serrano-Mayorga, CC Duque, S Ibáñez-Prada, ED Garcia-Gallo, E Arrieta, MPR Bastidas, A Rodríguez, A Martin-Loeches, I Reyes, LF A targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP) |
| title | A targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP) |
| title_full | A targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP) |
| title_fullStr | A targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP) |
| title_full_unstemmed | A targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP) |
| title_short | A targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP) |
| title_sort | targeted likelihood estimation comparing cefepime and piperacillin tazobactam in critically ill patients with community acquired pneumonia cap |
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