Efficacy and safety of piperacillin–tazobactam compared with meropenem in treating complicated urinary tract infections including acute pyelonephritis due to extended-spectrum β-lactamase-producing Enterobacteriaceae

Frontiers in Cellular and Infection Microbiology

Cellular and Infection Microbiology

Bo-Yuan Fan¹  Meng-Ying Li²  Chun-Yu Yan³  Fei Cui⁴  Lei Wang⁵  Yue Guan⁵  Jing-Wen Wang⁵  Jia Cui⁵  Wei Zhang⁵  Ting-Ting Fan⁵  Shan-Shan Cao⁵  Li Wang⁶  Bo Ji⁶  Shu-Rui Li⁷  Bin Cui⁸ 

[1] Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China;Department of Endocrinology, Xijing Hospital, The Fourth Military Medical University, Xi’an, China;Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom;Department of Pharmacy, Luoyang First People’s Hospital, Luoyang, China;Department of Pharmacy, Xijing Hospital, The Fourth Military Medical University, Xi’an, China;Department of Pharmacy, Yan’an University Affiliated Hospital, Yan’an, China;Department of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China;School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China;

关键词: complicated urinary tract infections;    piperacillin-tazobactam;    ESBL;    antibiotic treatment;    meropenem;   

DOI  :  10.3389/fcimb.2023.1093842

 received in 2022-11-18, accepted in 2023-03-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionExtended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae pose a huge threat to human health, especially in the context of complicated urinary tract infections (cUTIs). Carbapenems and piperacillin–tazobactam (PTZ) are two antimicrobial agents commonly used to treat cUTIs.MethodsA monocentric retrospective cohort study focused on the treatment of cUTIs in adults was conducted from January 2019 to November 2021. Patients with a positive urine culture strain yielding ≥ 103 colony-forming units per milliliter (CFU/mL), and sensitive to PTZ and carbapenems, were included. The primary endpoint was clinical success after antibiotic therapy. The secondary endpoint included rehospitalization and 90-day recurrence of cUTIs caused by ESBL-producing Enterobacteriaceae.ResultsOf the 195 patients included in this study, 110 were treated with PTZ while 85 were administered meropenem. The rate of clinical cure was similar between the PTZ and meropenem groups (80% vs. 78.8%, p = 0.84). However, the PTZ group had a lower duration of total antibiotic use (6 vs. 9; p < 0.01), lower duration of effective antibiotic therapy (6 vs. 8; p < 0.01), and lower duration of hospitalization (16 vs. 22; p < 0.01).DiscussionIn terms of adverse events, the safety of PTZ was higher than that of meropenem in the treatment of cUTIs.

【 授权许可】

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Copyright © 2023 Zhang, Yan, Li, Fan, Cao, Cui, Li, Fan, Ji, Wang, Cui, Cui, Wang, Guan and Wang