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This study aims to assess whether ertapenem as an empiric treatment of third-generation-cephalosporin resistant Enterobacteriaceae (3GCRE) bacteremia is non-inferior to other carbapenems in term of 30-day mortality.
There are limited data of the efficacy of ertapenem as the empiric treatment of serious invasive infections, such as bloodstream infections (BSIs), that are due to ESBL-producing Enterobacteriaceae. Previous studies of ertapenem were done in small group of patients, in less invasive infection, as a definite 'step-down' therapy, or as compared to other non-carbapenem antibiotics.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ertapenem | Patients who received ertapenem as an empirical antibiotic |
| |
| Other carbapenems | Patients who received carbapenems other than ertapenem as an empirical antibiotic |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ertapenem | Drug | Ertapenem injection |
| |
| Carbapenems |
| Measure | Description | Time Frame |
|---|---|---|
| 30-day mortality | death from any cause within 30 days after the blood culture with bacteraemia is drawn | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| In-hospital mortality | death from any cause within the duration of admission with bacteraemia | 90 days |
| 14-day mortality | death from any cause within 14 days after the blood culture with bacteraemia is drawn |
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Inclusion Criteria:
Exclusion Criteria:
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Patients 18 years of age and older admitted to Phramongkutklao Hospital, and Ananda Mahidol Hospital with 3GCRE monomicrobial bacteremia will be prospectively identified. In given a patient, only the initial episode of 3GCRE monomicrobial bacteremia during the study period will be included.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Phramongkutklao Hospital | Bangkok | 10400 | Thailand |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37252945 | Derived | Vasikasin V, Panuvatvanich B, Rawson TM, Holmes AH, Nasomsong W. Towards optimizing carbapenem selection in stewardship strategies: a prospective propensity score-matched study of ertapenem versus class 2 carbapenems for empirical treatment of third-generation cephalosporin-resistant Enterobacterales bacteraemia. J Antimicrob Chemother. 2023 Jul 5;78(7):1748-1756. doi: 10.1093/jac/dkad165. |
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| ID | Term |
|---|---|
| D016470 | Bacteremia |
| D001424 | Bacterial Infections |
| ID | Term |
|---|---|
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D018805 | Sepsis |
| D018746 | Systemic Inflammatory Response Syndrome |
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| ID | Term |
|---|---|
| D000077727 | Ertapenem |
| D015780 | Carbapenems |
| ID | Term |
|---|---|
| D047090 | beta-Lactams |
| D007769 | Lactams |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D006574 |
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| Drug |
Other carbapenems injection |
|
| 14 days |
| 90-day mortality | death from any cause within 90 days after the blood culture with bacteraemia is drawn | 90 days |
| • Length of stay | Duration of admission with bacteraemia | 90 days |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |