ArticleOpen forum infectious diseases2021
Meropenem Versus Piperacillin-Tazobactam for Definitive Treatment of Bloodstream Infections Caused by AmpC β-Lactamase-Producing
Article in Open forum infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02437045 (Pilot RCT of Meropenem Versus Piperacillin-Tazobactam for Definitive Treatment of Bloodstream Infections Caused by AmpC Beta-lactamase Producing Enterobacter Spp., Citrobacter Freundii, Morganella Morganii, Providencia Spp. or Serratia Marcescens. in Low-risk Patients), which is not on this map. Cited by 44 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pilot RCT of Meropenem Versus Piperacillin-Tazobactam for Definitive Treatment of Bloodstream Infections Caused by AmpC Beta-lactamase Producing Enterobacter Spp., Citrobacter Freundii, Morganella Morganii, Providencia Spp. or Serratia Marcescens. in Low-risk Patients
Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 88 citations in OpenAlex.
- Pooled it
- Impact of rapid antibiotic susceptibility testing for Gram-negative bacteremia varies by pathogen type and resistance: a secondary analysis of the RAPIDS GN trial.Microbiology spectrum · 2025Trial
- Antimicrobial Resistance of Serratia marcescens Recovered From Aquatic Environments: A Review.Environmental microbiology reports · 2026Review
- Bacterial L-forms: Key Mechanisms of Drug Resistance, Disease Recurrence, and Immune Evasion.Indian journal of microbiology · 2026Review
- Exploring heterogeneity in antibiotic choices for bloodstream infections caused by AmpC-producing enterobacterales: results from a case-vignette study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Antimicrobial susceptibility and distribution trends among inducible AmpC-producing Enterobacterales at a regional health authority in British Columbia: a 5-year retrospective review.Access microbiology · 2026Article
- Molecular Diagnostics, Antimicrobial Resistance Patterns, and Clinical Outcomes in Hospitalized Pneumonia Patients: A Prospective Study from Jordan and a Call for National Guideline Integration.Infection and drug resistance · 2026Article
- Antibiotics for Intra-Abdominal Infections: When, Which, How and How Long?Antibiotics (Basel, Switzerland) · 2025Review
- Modulation of NK Cell Properties by ESKAPE Group Bacteria.International journal of molecular sciences · 2025Article
- Cefepime Versus Carbapenem Therapy for the Treatment of Invasive Infections With Inducible Chromosomal AmpC-Producing Enterobacterales: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2025Article
- Characteristics and Outcomes of Patients Treated with Carbapenem Versus Non-carbapenem Therapy for AmpC-Producing Enterobacterales Bacteremia: A Retrospective Study.Infectious diseases and therapy · 2025Article
- Understanding and addressing β-lactam resistance mechanisms in gram-negative bacteria in Lebanon: A scoping review.Heliyon · 2025Review
- Piperacillin/Tazobactam Susceptibility Test Interpretive Criteria for Enterobacterales: Recommendations From the United States Committee on Antimicrobial Susceptibility Testing.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- An Update on Recent Clinical Trial Data in Bloodstream Infection.Antibiotics (Basel, Switzerland) · 2024Review
- Antibiotic Treatment of Infections Caused by AmpC-Producing Enterobacterales.Pharmacy (Basel, Switzerland) · 2024Review
- The impact of meropenem shortage and post-prescription review and feedback on broad-spectrum antimicrobial use: An interrupted time-series analysis.Infection prevention in practice · 2024Article
- Clinical Outcomes of Patients with AmpC-Beta-Lactamase-Producing Enterobacterales Bacteremia Treated with Carbapenems versus Non-Carbapenem Regimens: A Single-Center Study.Antibiotics (Basel, Switzerland) · 2024Article
- Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use.World journal of emergency surgery : WJES · 2024Review
- Antibiotic definitive treatment in ventilator associated pneumonia caused by AmpC-producing Enterobacterales in critically ill patients: a prospective multicenter observational study.Critical care (London, England) · 2024Observational
- Burden and Management of Multi-Drug Resistant Organism Infections in Solid Organ Transplant Recipients Across the World: A Narrative Review.Transplant international : official journal of the European Society for Organ Transplantation · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCarbapenems are recommended treatment for serious infections caused by AmpC-producing gram-negative bacteria but can select for carbapenem resistance. Piperacillin-tazobactam may be a suitable alternative.
methodsWe enrolled adult patients with bloodstream infection due to chromosomal AmpC producers in a multicenter randomized controlled trial. Patients were assigned 1:1 to receive piperacillin-tazobactam 4.5 g every 6 hours or meropenem 1 g every 8 hours. The primary efficacy outcome was a composite of death, clinical failure, microbiological failure, and microbiological relapse at 30 days.
resultsSeventy-two patients underwent randomization and were included in the primary analysis population. Eleven of 38 patients (29%) randomized to piperacillin-tazobactam met the primary outcome compared with 7 of 34 patients (21%) in the meropenem group (risk difference, 8% [95% confidence interval {CI}, -12% to 28%]). Effects were consistent in an analysis of the per-protocol population. Within the subcomponents of the primary outcome, 5 of 38 (13%) experienced microbiological failure in the piperacillin-tazobactam group compared to 0 of 34 patients (0%) in the meropenem group (risk difference, 13% [95% CI, 2% to 24%]). In contrast, 0% vs 9% of microbiological relapses were seen in the piperacillin-tazobactam and meropenem arms, respectively. Susceptibility to piperacillin-tazobactam and meropenem using broth microdilution was found in 96.5% and 100% of isolates, respectively. The most common AmpC β-lactamase genes identified were
conclusionsAmong patients with bloodstream infection due to AmpC producers, piperacillin-tazobactam may lead to more microbiological failures, although fewer microbiological relapses were seen. CLINICAL TRIALS REGISTRATION: NCT02437045.
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