Piperacillin/tazobactam versus carbapenems in the treatment of urinary tract infections caused by extended-spectrum beta-lactamases-producing Escherichia coli

ULU KILIÇ A., UYSAL B., METAN G., DEMİRASLAN H., DOĞANAY M.

23rd European Congress of Clinical Microbiology an Infectious Diseases, Germany, 1 - 04 April 2013, no.2089, pp.170

  • Publication Type: Conference Paper / Full Text
  • Country: Germany
  • Page Numbers: pp.170
  • Lokman Hekim University Affiliated: No

Abstract

Background: Infections caused by extended-spectrum beta-lactamase (ESBL) producing gram-negative bacteria
increasing widespread and it raises major concerns because of growing limitation of therapeutic alternatives.
Aim: To examine the clinical and microbiologic outcomes of piperacillin/tazobactam versus carbapenems in the
treatment of urinary tract infections (UTI) caused by ESBL-producing E.coli. Methods: This was a retrospective
study, comparing the clinical and microbiologic outcomes of patients receiving intravenous
piperacillin/tazobactam (4,5g q8h) or carbapenems (imipenem 500mg q6h, meropenem 1 g q8h or ertapenem 1g
q24h) in the treatment of urinary tract infections caused by ESBL-producing E.coli at Erciyes University,
School of Medicine, Kayseri in Turkey, during 2006-2010. Results: A total of 110 patients with urinary tract
infection caused by ESBL-E.coli have been identified. UTIs were classified as nosocomial in 22 (20 %) of
patients, health care associated in 65 (59 %) and community acquired in 23 (21 %) of them. Twenty- eight
(25.5%) of the UTIs were non-complicated and 82 (74.5%) of them were complicated. Fifty-five (50%) of
patients received carbapenems, 55 (50 %) of them received piperacillin/tazobactam according to the results of
antibiotic susceptibility testing. No statistically significant difference between patients receiving
piperacillin/tazobactam and carbapenems in terms of demographic characteristics, comorbidities, presence of
urinary catheter, bacteremia, therapeutic failure and relapse. Median duration of treatment and hospitalization
was shorter with patients treated with piperacillin/tazobactam than carbapenems (10, 12 days and 11, 13 days
respectively). Conclusion: Effectiveness of these two groups of antibiotics in the treatment of UTIs caused by
ESBL-producing E.coli was similar. Patients treated piperacillin/tazobactam has shorter duration of treatment
and hospitalization (p<0,05).