Pharmacodynamic evaluation of piperacillin/tazobactam versus meropenem against extended-spectrum ß-lactamase-producing and non-producing Escherichia coli clinical isolates in a hollow-fibre infection model.
J Antimicrob Chemother
; 77(9): 2448-2455, 2022 08 25.
Article
em En
| MEDLINE
| ID: mdl-35724128
ABSTRACT
BACKGROUND:
Urosepsis caused by extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli is increasing worldwide. Carbapenems are commonly recommended for the treatment of ESBL infections; however, to minimize the emergence of carbapenem resistance, interest in alternative treatments has heightened.OBJECTIVES:
This study compared pharmacodynamics of piperacillin/tazobactam versus meropenem against ESBL-producing and non-producing E. coli clinical isolates.METHODS:
E. coli isolates, obtained from national reference laboratory in Bangladesh, were characterized by phenotypic tests, WGS, susceptibility tests and mutant frequency analysis. Three ESBL-producing and two non-producing E. coli were exposed to piperacillin/tazobactam (4.5â g, every 6â h and every 8â h, 30â min infusion) and meropenem (1â g, every 8â h, 30â min infusion) in a hollow-fibre infection model over 7â days.RESULTS:
Piperacillin/tazobactam regimens attained â¼4-5â log10 cfu/mL bacterial killing within 24â h and prevented resistance emergence over the experiment against ESBL-producing and non-producing E. coli. However, compared with 8 hourly meropenem, the 6 hourly piperacillin/tazobactam attained â¼1â log10 lower bacterial kill against one of three ESBL-producing E. coli (CTAP#173) but comparable killing for the other two ESBL-producing (CTAP#168 and CTAP#169) and two non-producing E. coli (CTAP#179 and CTAP#180). The 6 hourly piperacillin/tazobactam regimen attained â¼1â log10 greater bacterial kill compared with the 8 hourly regimen against CTAP#168 and CTAP#179 at 24â h.CONCLUSIONS:
Our study suggests piperacillin/tazobactam may be a potential alternative to carbapenems to treat urosepsis caused by ESBL-producing E. coli, although clinical trials with robust design are needed to confirm non-inferiority of outcome.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Escherichia coli
/
Infecções por Escherichia coli
Limite:
Humans
Idioma:
En
Revista:
J Antimicrob Chemother
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Austrália