Zha, Lei, Li, Xiang, Ren, Zhichu, Zhang, Dayan, Zou, Yi, Pan, Lingling, Li, Shirong, Chen, Shanghua and Tefsen, Boris 
ORCID: 0000-0001-6668-217X
(2022)
Pragmatic Comparison of Piperacillin/Tazobactam versus Carbapenems in Treating Patients with Nosocomial Pneumonia Caused by Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i>.
ANTIBIOTICS-BASEL, 11 (10).
1384-.
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Abstract
The effectiveness of piperacillin/tazobactam for managing nosocomial pneumonia caused by extended-spectrum β-lactamase (ESBL)-producing <i>Enterobacteriaceae</i> is unknown. To answer this question, we conducted a retrospective cohort study in two tertiary teaching hospitals of patients admitted between January 2018 and July 2021 with a diagnosis of nosocomial pneumonia caused by ESBL-producing <i>K. pneumoniae</i> receiving either piperacillin/tazobactam or carbapenems within 24 h from the onset of pneumonia for at least 72 h. Clinical outcomes, including 28-day mortality and 14-day clinical and microbiological cure, were analyzed. Of the 136 total patients, 64 received piperacillin/tazobactam and 72 received carbapenems. The overall 28-day mortality was 19.1% (26/136). In the inverse probability of treatment weighted cohort, piperacillin/tazobactam therapy was not associated with worse clinical outcomes, as the 28-day mortality (OR, 0.82, 95% CI, 0.23-2.87, <i>p</i> = 0.748), clinical cure (OR, 0.94, 95% CI, 0.38-2.35, <i>p</i> = 0.894), and microbiological cure (OR, 1.10, 95% CI, 0.53-2.30, <i>p</i> = 0.798) were comparable to those of carbapenems. Subgroup analyses also did not demonstrate any statistical differences. In conclusion, piperacillin/tazobactam could be an effective alternative to carbapenems for treating nosocomial pneumonia due to ESBL-producing <i>K. pneumoniae</i> when the MICs are ≤8 mg/L.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | carbapenem, ESBL, Klebsiella pneumoniae, nosocomial infection, pneumonia, piperacillin, tazobactam |
| Divisions: | Faculty of Health and Life Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 06 Jul 2023 13:47 |
| Last Modified: | 18 Oct 2023 09:55 |
| DOI: | 10.3390/antibiotics11101384 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3171496 |
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