Imipenem, Meropenem or Doripenem to Treat Patients with Pseudomonas aeruginosa Ventilator-Associated Pneumonia.

Link to article at PubMed

Related Articles

Imipenem, Meropenem or Doripenem to Treat Patients with Pseudomonas aeruginosa Ventilator-Associated Pneumonia.

Antimicrob Agents Chemother. 2013 Dec 16;

Authors: Luyt CE, Aubry A, Lu Q, Micaelo M, Bréchot N, Brossier F, Brisson H, Rouby JJ, Trouillet JL, Combes A, Jarlier V, Chastre J

Abstract
Only limited data exist on Pseudomonas aeruginosa-VAP treated with imipenem, meropenem or doripenem. Therefore, we conducted a prospective observational study in 169 patients who developed Pseudomonas aeruginosa VAP. Imipenem, meropenem and doripenem MICs of Pseudomonas aeruginosa isolates were determined using E-tests and compared according to the carbapenem received. Among the 169 isolates responsible for the first VAP episode, doripenem MICs were lower (p < 0.0001) than those of imipenem and meropenem (MIC50 of 0.25, 2 and 0.38, respectively); 61%, 64% or 70% were susceptible to imipenem, meropenem or doripenem, respectively (NS). Factors independently associated with carbapenem resistance were previous carbapenem use (within 15 days) and mechanical ventilation duration before VAP onset. Fifty-six (33%) patients had at least one VAP recurrence and 56 (33%) died. Factors independently associated with an unfavorable outcome (recurrence or death) were high day-7 SOFA score and mechanical ventilation dependency on day 7. Physicians freely prescribed a carbapenem to 88 patients: imipenem for 32, meropenem for 24 and doripenem for 32. The remaining 81 patients were treated with various antibiotics. Imipenem-, meropenem- or doripenem-treated patients, respectively, had similar VAP recurrence (41%, 25% or 22%; p = 0.15) and mortality rates (47%, 25% or 22%, p = 0.07). Carbapenem-resistance emerged similarly among patients treated with any carbapenem. No carbapenem was superior to another for preventing carbapenem-resistance emergence.

PMID: 24342638 [PubMed - as supplied by publisher]

Leave a Reply

Your email address will not be published. Required fields are marked *

Imipenem, Meropenem or Doripenem to Treat Patients with Pseudomonas aeruginosa Ventilator-Associated Pneumonia.

Link to article at PubMed

Related Articles

Imipenem, Meropenem or Doripenem to Treat Patients with Pseudomonas aeruginosa Ventilator-Associated Pneumonia.

Antimicrob Agents Chemother. 2013 Dec 16;

Authors: Luyt CE, Aubry A, Lu Q, Micaelo M, Bréchot N, Brossier F, Brisson H, Rouby JJ, Trouillet JL, Combes A, Jarlier V, Chastre J

Abstract
Only limited data exist on Pseudomonas aeruginosa-VAP treated with imipenem, meropenem or doripenem. Therefore, we conducted a prospective observational study in 169 patients who developed Pseudomonas aeruginosa VAP. Imipenem, meropenem and doripenem MICs of Pseudomonas aeruginosa isolates were determined using E-tests and compared according to the carbapenem received. Among the 169 isolates responsible for the first VAP episode, doripenem MICs were lower (p < 0.0001) than those of imipenem and meropenem (MIC50 of 0.25, 2 and 0.38, respectively); 61%, 64% or 70% were susceptible to imipenem, meropenem or doripenem, respectively (NS). Factors independently associated with carbapenem resistance were previous carbapenem use (within 15 days) and mechanical ventilation duration before VAP onset. Fifty-six (33%) patients had at least one VAP recurrence and 56 (33%) died. Factors independently associated with an unfavorable outcome (recurrence or death) were high day-7 SOFA score and mechanical ventilation dependency on day 7. Physicians freely prescribed a carbapenem to 88 patients: imipenem for 32, meropenem for 24 and doripenem for 32. The remaining 81 patients were treated with various antibiotics. Imipenem-, meropenem- or doripenem-treated patients, respectively, had similar VAP recurrence (41%, 25% or 22%; p = 0.15) and mortality rates (47%, 25% or 22%, p = 0.07). Carbapenem-resistance emerged similarly among patients treated with any carbapenem. No carbapenem was superior to another for preventing carbapenem-resistance emergence.

PMID: 24342638 [PubMed - as supplied by publisher]

Leave a Reply

Your email address will not be published. Required fields are marked *