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Antibiotic Therapy for Klebsiella pneumoniae Bacteremia: Implications of Production of Extended-Spectrum -Lactamases
Open accessAbstract
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.
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Cited by
Kalil, A. C., Metersky, M. L., Klompas, M., Muscedere, J., Sweeney, D. A., Palmer, L. B., Napolitano, L. M., O'Grady, N. P., Bartlett, J. G., Carratalà, J., et al. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/ciw353 · Cited by 3,892
Cosgrove, S. E. (2006) · Clinical Infectious Diseases · doi:10.1086/499406 · Cited by 1,271
Resistance in Gram-Negative Bacteria: Enterobacteriaceae
Paterson, D. L. (2006) · The American Journal of Medicine · doi:10.1016/j.amjmed.2006.03.013 · Cited by 874
Self-citationJacoby, G. A., & Munoz-Price, L. S. (2005) · New England Journal of Medicine · doi:10.1056/nejmra041359 · Cited by 787
The Surgical Infection Society Revised Guidelines on the Management of Intra-Abdominal Infection
Mazuski, J. E., Tessier, J. M., May, A. K., Sawyer, R. G., Nadler, E. P., Rosengart, M. R., Chang, P. K., O'Neill, P. J., Mollen, K. P., Huston, J. M., et al. (2017) · Surgical Infections · doi:10.1089/sur.2016.261 · Cited by 573
Metadata
- Authors
- Paterson, D. L., Ko, W.-C., Von Gottberg, A., Mohapatra, S., Casellas, J. M., Goossens, H., Mulazimoglu, L., Trenholme, G., Klugman, K. P., Bonomo, R. A., Rice, L. B., Wagener, M. M., McCormack, J. G., & Yu, V. L.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-07-01
- Volume
- 39
- Issue
- 1
- Pages
- 31-37
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2163832044
- Cited by
- 571
- References
- 0
- FWCI
- 16.08
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Paterson, D. L., Ko, W.-C., Von Gottberg, A., Mohapatra, S., Casellas, J. M., Goossens, H., Mulazimoglu, L., Trenholme, G., Klugman, K. P., Bonomo, R. A., Rice, L. B., Wagener, M. M., McCormack, J. G., & Yu, V. L. (2004). Antibiotic Therapy for Klebsiella pneumoniae Bacteremia: Implications of Production of Extended-Spectrum -Lactamases. Clinical Infectious Diseases. https://doi.org/10.1086/420816
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