| Title |
Efficacy and safety of de-escalation therapy to ertapenem for treatment of infections caused by extended-spectrum-β-lactamase-producing Enterobacteriaceae: an open-label randomized controlled trial
|
|---|---|
| Published in |
BMC Infectious Diseases, March 2017
|
| DOI | 10.1186/s12879-017-2284-1 |
| Pubmed ID | |
| Authors |
Pinyo Rattanaumpawan, Peerawong Werarak, Anupop Jitmuang, Pattarachai Kiratisin, Visanu Thamlikitkul |
| Abstract |
Carbapenem antibiotics are considered the treatment of choice for serious extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria (GNB) infections. The study objectives were to evaluate efficacy and safety of de-escalation therapy to ertapenem for treatment of infections caused by extended-spectrum-β-lactamase-producing Enterobacteriaceae. We conducted a randomized controlled trial of adult patients with documented ESBL-producing Enterobacteriaceae infections who had received any group 2 carbapenem for less than 96 h. In the intervention group, the previously-prescribed group 2 carbapenem was de-escalated to ertapenem. In the control group, the group 2 carbapenem was continued. During June 2011-December 2014, 32 patients were randomized to the de-escalation group and 34 to the control group. Most common sites of infection were urinary tract infection (42%). Characteristics of both groups were comparable. By using a 15% predefined margin, ertapenem was non-inferior to control group regarding the clinical cure rate (%Δ = 14.0 [95% confidence interval: -2.4 to 31.1]), the microbiological eradication rate (%Δ = 4.1 [-5.0 to 13.4]), and the superimposed infection rate (%Δ = -16.5 [-38.4 to 5.3]). Patients in the de-escalation group had a significantly lower 28-day mortality rate (9.4% vs. 29.4%; P = .05), a significantly shorter median length of stay (16.5 days [4.0-73.25] vs. 20.0 days [1.0-112.25]; P = .04), and a significantly lower defined daily dose of carbapenem use (12.9 ± 8.9 vs. 18.4 ± 12.6; P = .05). Ertapenem could be safely used as de-escalation therapy for ESBL-producing Enterobacteriaceae infections, once the susceptibility profiles are known. Future studies are needed to investigate ertapenem efficacy against ESBL-producing Enterobacteriaceae pneumonia to determine its applicability in life-threatening conditions. ClinicalTrials.gov identifier: NCT01297842 . Registered on 14 February 2011. First patient enrolled on 27 June 2011. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Venezuela, Bolivarian Republic of | 1 | 33% |
| Unknown | 2 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Scientists | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 96 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 96 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 13 | 14% |
| Researcher | 11 | 11% |
| Other | 10 | 10% |
| Student > Ph. D. Student | 10 | 10% |
| Student > Bachelor | 9 | 9% |
| Other | 14 | 15% |
| Unknown | 29 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 35 | 36% |
| Pharmacology, Toxicology and Pharmaceutical Science | 13 | 14% |
| Immunology and Microbiology | 7 | 7% |
| Nursing and Health Professions | 4 | 4% |
| Engineering | 3 | 3% |
| Other | 2 | 2% |
| Unknown | 32 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 March 2017.
All research outputs
#3,041,766
of 24,832,302 outputs
Outputs from BMC Infectious Diseases
#984
of 8,344 outputs
Outputs of similar age
#54,089
of 316,457 outputs
Outputs of similar age from BMC Infectious Diseases
#27
of 154 outputs
Altmetric has tracked 24,832,302 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,344 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.6. This one has done well, scoring higher than 88% of its peers.
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We're also able to compare this research output to 154 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 83% of its contemporaries.