Title
Antibiotic therapy for Klebsiella pneumoniae bacteremia : implications of production of extended-spectrum β-lactamases Antibiotic therapy for Klebsiella pneumoniae bacteremia : implications of production of extended-spectrum β-lactamases
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Chicago, Ill. ,
Subject
Biology
Human medicine
Source (journal)
Clinical infectious diseases. - Chicago, Ill.
Volume/pages
39(2004) :1 , p. 31-37
ISSN
1058-4838
ISI
000222087800007
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
The prevalence of extended-spectrum beta-lactamase (ESBL) production by Klebsiella pneumonia approaches 50% in some countries, with particularly high rates in eastern Europe and Latin America. No randomized trials have ever been performed on treatment of bacteremia due to ESBL-producing organisms; existing data comes only from retrospective, single-institution studies. In a prospective study of 455 consecutive episodes of Klebsiella pneumoniae bacteremia in 12 hospitals in 7 countries, 85 episodes were due to an ESBL-producing organism. Failure to use an antibiotic active against ESBL-producing K. pneumoniae was associated with extremely high mortality. Use of a carbapenem ( primarily imipenem) was associated with a significantly lower 14-day mortality than was use of other antibiotics active in vitro. Multivariate analysis including other predictors of mortality showed that use of a carbapenem during the 5-day period after onset of bacteremia due to an ESBL-producing organism was independently associated with lower mortality. Antibiotic choice is particularly important in seriously ill patients with infections due to ESBL-producing K. pneumoniae.
E-info
https://repository.uantwerpen.be/docman/iruaauth/18c905/9203920.pdf
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