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Hoshi T, Fujii S, Watanabe K, Fukumura Y, Miyazaki K, Takahashi M, Taniguchi S, Kimura S, Saito A, Wada N, Saijo M, Yamada K, Iwayama K, Itaya M, Sato H. Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing Escherichia coli Bacteremia. Infect Dis Rep 2023; 16:26-34. [PMID: 38247975 PMCID: PMC10801497 DOI: 10.3390/idr16010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
Carbapenems are antimicrobial agents commonly used to treat extended-spectrum β-lactamase (ESBL)-producing bacteria. Although cefmetazole (CMZ) is considered effective for ESBL-producing Escherichia coli (ESBL-EC) bacteremia, previous studies showed its limitations, including the influence of the initial antimicrobial agent. Here, we examined the effects of different approaches to antimicrobial therapy with CMZ and meropenem (MEPM) on the time to defervescence in ESBL-EC bacteremia. Notably, the influence of previous antimicrobial agents was excluded. Inpatients with ESBL-EC detected in blood cultures between April 2018 and March 2023 were included and assigned to CMZ (n = 14), MEPM (n = 8), de-escalation to CMZ (dCMZ; n = 9), or escalation to MEPM (eMEPM; n = 11) groups. The median time to defervescence was 3.5, 1.0, 2.0, and 4.0 days in the CMZ, MEPM, dCMZ, and eMEPM groups, respectively, with no significant differences. Cox proportional hazards analysis showed a significant difference in the hazard ratio (95% confidence interval) of 0.378 (0.145-0.984) for the time to defervescence with CMZ versus MEPM (p = 0.046). The extent of a delayed time to defervescence is greater with early CMZ administration than with MEPM administration in patients with non-severe ESBL-EC bacteremia.
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Affiliation(s)
- Takanobu Hoshi
- Division of Clinical Pharmacy, Department of Pharmacy, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo-shi 006-8585, Hokkaido, Japan; (T.H.); (K.I.); (H.S.)
| | - Satoshi Fujii
- Department of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo-shi 060-8543, Hokkaido, Japan
| | - Kei Watanabe
- Department of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan; (K.W.); (Y.F.); (K.M.); (M.T.); (S.T.); (S.K.); (A.S.); (M.I.)
| | - Yuta Fukumura
- Department of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan; (K.W.); (Y.F.); (K.M.); (M.T.); (S.T.); (S.K.); (A.S.); (M.I.)
| | - Koji Miyazaki
- Department of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan; (K.W.); (Y.F.); (K.M.); (M.T.); (S.T.); (S.K.); (A.S.); (M.I.)
| | - Madoka Takahashi
- Department of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan; (K.W.); (Y.F.); (K.M.); (M.T.); (S.T.); (S.K.); (A.S.); (M.I.)
| | - Sakae Taniguchi
- Department of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan; (K.W.); (Y.F.); (K.M.); (M.T.); (S.T.); (S.K.); (A.S.); (M.I.)
| | - Shingo Kimura
- Department of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan; (K.W.); (Y.F.); (K.M.); (M.T.); (S.T.); (S.K.); (A.S.); (M.I.)
| | - Arisa Saito
- Department of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan; (K.W.); (Y.F.); (K.M.); (M.T.); (S.T.); (S.K.); (A.S.); (M.I.)
| | - Naoki Wada
- Department of Clinical Laboratory, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan;
| | - Masaji Saijo
- Department of Primary Care, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan;
| | - Kazunori Yamada
- Department of Pharmacy, Nakamura Memorial Hospital, Sapporo-shi 060-8570, Hokkaido, Japan;
| | - Kuninori Iwayama
- Division of Clinical Pharmacy, Department of Pharmacy, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo-shi 006-8585, Hokkaido, Japan; (T.H.); (K.I.); (H.S.)
| | - Marie Itaya
- Department of Pharmacy, Sapporo Tokushukai Hospital, Sapporo-shi 004-0041, Hokkaido, Japan; (K.W.); (Y.F.); (K.M.); (M.T.); (S.T.); (S.K.); (A.S.); (M.I.)
| | - Hideki Sato
- Division of Clinical Pharmacy, Department of Pharmacy, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo-shi 006-8585, Hokkaido, Japan; (T.H.); (K.I.); (H.S.)
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