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Real-life temocillin use in Greater Paris area, effectiveness and risk factors for failure in infections caused by ESBL-producing Enterobacterales: a multicentre retrospective study.
- Source :
-
JAC-antimicrobial resistance [JAC Antimicrob Resist] 2022 Dec 29; Vol. 5 (1), pp. dlac132. Date of Electronic Publication: 2022 Dec 29 (Print Publication: 2023). - Publication Year :
- 2022
-
Abstract
- Background: Temocillin is a β-lactam that is not hydrolysed by ESBLs.<br />Objectives: To describe the real-life use of temocillin, to assess its effectiveness in infections caused by ESBL-producing Enterobacterales, and to identify risk factors for treatment failure.<br />Methods: Retrospective multicentric study in eight tertiary care hospitals in the Greater Paris area, including patients who received at least one dose of temocillin for ESBL infections from 1 January to 31 December 2018. Failure was a composite criterion defined within 28 day follow-up by persistence or reappearance of signs of infection, and/or switch to suppressive antibiotic treatment and/or death from infection. A logistic regression with univariable and multivariable analysis was performed to identify risks associated with failure.<br />Results: Data on 130 infection episodes were collected; 113 were due to ESBL-producing Enterobacterales. Mean age was 65.2 ± 15.7 years and 68.1% patients were male. Indications were mostly urinary tract infections (UTIs) (85.8%), bloodstream infections (11.5%), respiratory tract infections (RTIs) (3.5%) and intra-abdominal infections (3.5%). Bacteria involved were Escherichia coli (49.6%), Klebsiella pneumoniae (44.2%) and Enterobacter cloacae (8.8%). Polymicrobial infections occurred in 23.0% of cases. Temocillin was mostly used in monotherapy (102/113, 90.3%). Failure was found in 13.3% of cases. Risk factors for failure in multivariable analysis were: RTI (aOR 23.3, 95% CI 1.5-358.2) and neurological disease (aOR 5.3, 95% CI 1.5-18.6).<br />Conclusions: The main use of temocillin was UTI due to ESBL-producing E. coli and K. pneumoniae , with a favourable clinical outcome. The main risk factor for failure was neurological disease.<br /> (© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)
Details
- Language :
- English
- ISSN :
- 2632-1823
- Volume :
- 5
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- JAC-antimicrobial resistance
- Publication Type :
- Academic Journal
- Accession number :
- 36601547
- Full Text :
- https://doi.org/10.1093/jacamr/dlac132