Are Carbapenems Better Than Piperacillin-Tazobactam for Bacteremia with ESBL-Producing Enterobacterales?

Not so sure — both had similar outcomes in a large noninferiority study, but carbapenem treatment was more likely to generate carbapenem-resistant microorganisms.

Antibiotic resistance among extended-spectrum beta-lactamase (ESBL)–producing Enterobacterales (including carbapenem-resistant organisms) is rapidly emerging worldwide. In the MERINO trial, patients having bloodstream infections with ESBL-producing Enterobacterales (EPE) had better outcomes with carbapenems than with piperacillin-tazobactam; nonetheless, antibiotic stewardship programs restrict carbapenem use to appropriate situations to reduce resistance. So, are carbapenems really better than piperacillin-tazobactam for EPE bacteremia?

Månsson and colleagues assessed 30-day all-cause mortality among 644 patients who received piperacillin-tazobactam or a carbapenem for EPE bacteremia at 9 Swedish hospitals from 2013 through 2022. Across the…

Reviewing Author

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

Are Carbapenems Better Than Piperacillin-Tazobactam for Bacteremia with ESBL-Producing Enterobacterales?

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Reviewing Author