Cefoxitin versus carbapenems as definitive treatment for extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteremia in intensive care unit: a propensity-matched retrospective analysis
Authors' conclusion
Our results suggest that cefoxitin as definitive antibiotic therapy could be a therapeutic option for some ESBL-KP bacteremia, sparing carbapenems and reducing the selection of carbapenem-resistant Pseudomonas aeruginosa strains.
Study context
- Population
- ICU patients with monomicrobial extended-spectrum beta-lactamases (ESBL)-producing Klebsiella pneumoniae bacteremia, University Hospital of Guadeloupe, 2013–2023
- Participants
- 110 patients
- Exposure
- Cefoxitin vs carbapenems as definitive antibiotic therapy
- Cefoxitinn = 63
- Carbapenemsn = 47reference
- Outcome
- Clinical success (composite:
- 30-day survival
- Absence of relapse
- No change of antibiotic therapy)
- Follow-up
- 30 days
Methodological detailspropensity-score matched, single-centre
- Propensity-score matched
- Single-centre
Main finding
As reported in the abstract
P = 0.823
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Cefoxitin | Carbapenems | P value |
|---|---|---|---|
| Change of definitive antibiotic therapy | 17% | 0% | P = 0.002 |
Other secondary endpoints
- No significant differences
Safety
Acquisition of carbapenem-resistant Pseudomonas aeruginosa
P = 0.007
Original publication
Cefoxitin versus carbapenems as definitive treatment for extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteremia in intensive care unit: a propensity-matched retrospective analysis. Crit Care. Published 1 November 2023. doi:10.
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