TY - JOUR
T1 - Impact of the MIC of piperacillin/tazobactam on the outcome for patients with bacteraemia due to Enterobacteriaceae: The Bacteraemia-MIC project
AU - Delgado-Valverde, Mercedes
AU - Torres, Eva
AU - Valiente-Mendez, Adoración
AU - Almirante, Benito
AU - Gómez-Zorrilla, Silvia
AU - Borrell, Núria
AU - Corzo, Juan E.
AU - Gurgui, Mercedes
AU - Almela, Manuel
AU - García-álvarez, Lara
AU - Fontecoba-Sánchez, María Cruz
AU - Martínez-Martínez, Luis
AU - Cantón, Rafael
AU - Praena, Julia
AU - Causse, Manuel
AU - Gutiérrez-Gutiérrez, Belén
AU - Roberts, Jason A.
AU - Farkas, Andras
AU - Pascual, Álvaro
AU - Rodríguez-Baño, Jesúson
AU - de Cueto, Marina
AU - Planes Reig, Ana Maria
AU - Quintano, Fe Tubau
AU - Peña, Carmen
AU - Galán Otalora, M. Elvira
AU - Alegría, Carlos Ruíz de
AU - Morosini, M. Isabel
AU - Lepe, José Antonio
AU - Cisneros, José Miguel
AU - Morey, Shawna
AU - Abdul-Aziz, Mohd Hafiz
PY - 2016/2/1
Y1 - 2016/2/1
N2 - © 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.
AB - © 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.
U2 - 10.1093/jac/dkv362
DO - 10.1093/jac/dkv362
M3 - Article
VL - 71
SP - 521
EP - 530
IS - 2
M1 - dkv362
ER -