Impact of the MIC of piperacillin/tazobactam on the outcome for patients with bacteraemia due to Enterobacteriaceae: The Bacteraemia-MIC project

Mercedes Delgado-Valverde, Eva Torres, Adoración Valiente-Mendez, Benito Almirante, Silvia Gómez-Zorrilla, Núria Borrell, Juan E. Corzo, Mercedes Gurgui, Manuel Almela, Lara García-álvarez, María Cruz Fontecoba-Sánchez, Luis Martínez-Martínez, Rafael Cantón, Julia Praena, Manuel Causse, Belén Gutiérrez-Gutiérrez, Jason A. Roberts, Andras Farkas, Álvaro Pascual, Jesúson Rodríguez-BañoMarina de Cueto, Ana Maria Planes Reig, Fe Tubau Quintano, Carmen Peña, M. Elvira Galán Otalora, Carlos Ruíz de Alegría, M. Isabel Morosini, José Antonio Lepe, José Miguel Cisneros, Shawna Morey, Mohd Hafiz Abdul-Aziz

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12 Citations (Scopus)

Abstract

© The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Objective: Our objective was to evaluate the impact of low versus borderline MIC of piperacillin/tazobactam on the clinical outcomes of patients with bacteraemia caused by Enterobacteriaceae who were treated with that antimicrobial. Patients and methods: A prospective observational multicentre cohort study was conducted in 13 Spanish university hospitals. Patients >17 years old with bacteraemia due to Enterobacteriaceae who received empirical piperacillin/tazobactam treatment for at least 48 h were included. Outcome variables were clinical response at day 21, clinical response at end of treatment with piperacillin/tazobactam and all-cause 30 day mortality. Univariate and multivariate logistic regression analyses were performed. Results: Overall, 275 patients were included in the analysis; 248 (90.2%) in the low MIC group (≤4 mg/L) and 27 (9.8%) in the borderline MIC group (8-16 mg/L). The biliary tract was the most common source of infection (48.4%) and Escherichia coli was the most frequent pathogen (63.3%). Crude 30 day mortality rates were 10.5% and 11.1% for the low MIC group and the borderline MIC group, respectively (relative risk = 1.06, 95% CI = 0.34-3.27, P = 1). Multivariate analysis of failure at day 21 and at end of treatment with piperacillin/tazobactam and 30 day mortality showed no trend towards increased clinical failure or mortality with borderline MICs (OR = 0.96, 95% CI = 0.18-4.88, P = 0.96; OR = 0.47, 95% CI = 0.10-2.26, P = 0.35; OR = 1.48, 95% CI = 0.33-6.68, P = 0.6). Conclusions: We did not find that higher piperacillin/tazobactam MIC within the susceptible or intermediate susceptibility range had a significant influence on the outcome for patients with bacteraemia due to Enterobacteriaceae.
Original languageEnglish
Article numberdkv362
Pages (from-to)521-530
JournalJournal of Antimicrobial Chemotherapy
Volume71
Issue number2
DOIs
Publication statusPublished - 1 Feb 2016

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