Please use this identifier to cite or link to this item:
https://doi.org/10.1093/ofid/ofab387
DC Field | Value | |
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dc.title | Meropenem Versus Piperacillin-Tazobactam for Definitive Treatment of Bloodstream Infections Caused by AmpC β-Lactamase-Producing Enterobacter spp, Citrobacter freundii, Morganella morganii, Providencia spp, or Serratia marcescens: A Pilot Multicenter Randomized Controlled Trial (MERINO-2) | |
dc.contributor.author | Stewart, AG | |
dc.contributor.author | Paterson, DL | |
dc.contributor.author | Young, B | |
dc.contributor.author | Lye, DC | |
dc.contributor.author | Davis, JS | |
dc.contributor.author | Schneider, K | |
dc.contributor.author | Yilmaz, M | |
dc.contributor.author | Dinleyici, R | |
dc.contributor.author | Runnegar, N | |
dc.contributor.author | Henderson, A | |
dc.contributor.author | Archuleta, S | |
dc.contributor.author | Kalimuddin, S | |
dc.contributor.author | Forde, BM | |
dc.contributor.author | Chatfield, MD | |
dc.contributor.author | Bauer, MJ | |
dc.contributor.author | Lipman, J | |
dc.contributor.author | Harris-Brown, T | |
dc.contributor.author | Harris, PNA | |
dc.date.accessioned | 2021-11-15T09:03:46Z | |
dc.date.available | 2021-11-15T09:03:46Z | |
dc.date.issued | 2021-08-01 | |
dc.identifier.citation | Stewart, AG, Paterson, DL, Young, B, Lye, DC, Davis, JS, Schneider, K, Yilmaz, M, Dinleyici, R, Runnegar, N, Henderson, A, Archuleta, S, Kalimuddin, S, Forde, BM, Chatfield, MD, Bauer, MJ, Lipman, J, Harris-Brown, T, Harris, PNA (2021-08-01). Meropenem Versus Piperacillin-Tazobactam for Definitive Treatment of Bloodstream Infections Caused by AmpC β-Lactamase-Producing Enterobacter spp, Citrobacter freundii, Morganella morganii, Providencia spp, or Serratia marcescens: A Pilot Multicenter Randomized Controlled Trial (MERINO-2). Open Forum Infectious Diseases 8 (8) : ofab387-. ScholarBank@NUS Repository. https://doi.org/10.1093/ofid/ofab387 | |
dc.identifier.issn | 23288957 | |
dc.identifier.uri | https://scholarbank.nus.edu.sg/handle/10635/206194 | |
dc.description.abstract | Background: Carbapenems are recommended treatment for serious infections caused by AmpC-producing gram-negative bacteria but can select for carbapenem resistance. Piperacillin-tazobactam may be a suitable alternative. Methods: We enrolled adult patients with bloodstream infection due to chromosomal AmpC producers in a multicenter randomized controlled trial. Patients were assigned 1:1 to receive piperacillin-tazobactam 4.5 g every 6 hours or meropenem 1 g every 8 hours. The primary efficacy outcome was a composite of death, clinical failure, microbiological failure, and microbiological relapse at 30 days. Results: Seventy-two patients underwent randomization and were included in the primary analysis population. Eleven of 38 patients (29%) randomized to piperacillin-tazobactam met the primary outcome compared with 7 of 34 patients (21%) in the meropenem group (risk difference, 8% [95% confidence interval {CI},-12% to 28%]). Effects were consistent in an analysis of the per-protocol population. Within the subcomponents of the primary outcome, 5 of 38 (13%) experienced microbiological failure in the piperacillin-tazobactam group compared to 0 of 34 patients (0%) in the meropenem group (risk difference, 13% [95% CI, 2% to 24%]). In contrast, 0% vs 9% of microbiological relapses were seen in the piperacillin-tazobactam and meropenem arms, respectively. Susceptibility to piperacillin-tazobactam and meropenem using broth microdilution was found in 96.5% and 100% of isolates, respectively. The most common AmpC β-lactamase genes identified were blaCMY-2, blaDHA-17, blaCMH-3, and blaACT-17. No ESBL, OXA, or other carbapenemase genes were identified. Conclusions: Among patients with bloodstream infection due to AmpC producers, piperacillin-tazobactam may lead to more microbiological failures, although fewer microbiological relapses were seen. Clinical Trials Registration: NCT02437045. | |
dc.publisher | Oxford University Press (OUP) | |
dc.source | Elements | |
dc.subject | Enterobacterales | |
dc.subject | ampC β-lactamase | |
dc.subject | carbapenem | |
dc.subject | clinical trial | |
dc.subject | piperacillin-tazobactam | |
dc.type | Article | |
dc.date.updated | 2021-11-11T06:10:17Z | |
dc.contributor.department | MEDICINE | |
dc.contributor.department | DUKE-NUS MEDICAL SCHOOL | |
dc.description.doi | 10.1093/ofid/ofab387 | |
dc.description.sourcetitle | Open Forum Infectious Diseases | |
dc.description.volume | 8 | |
dc.description.issue | 8 | |
dc.description.page | ofab387- | |
dc.published.state | Published | |
Appears in Collections: | Elements Staff Publications |
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Meropenem Versus Piperacillin-Tazobactam for Definitive Treatment of Bloodstream Infections Caused by AmpC β-Lactamase-Produ.pdf | Published version | 693.38 kB | Adobe PDF | OPEN | Published | View/Download |
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