Evidence map›Paper›PMID 36959425›Full record

ArticleAnnals of intensive care2023

Efficacy of carbapenem vs non carbapenem β-lactam therapy as empiric antimicrobial therapy in patients with extended-spectrum β-lactamase-producing Enterobacterales urinary septic shock: a propensity-weighted multicenter cohort study.

Erwann Cariou, Romain Griffier, Arthur Orieux, Stein Silva, Stanislas Faguer, Thierry Seguin, Saad Nseir, Emmanuel Canet, Arnaud Desclaux, Bertrand Souweine and 9 more

Open access · goldFull text read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of intensive care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.3field-weighted citation impact, top 56% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 3 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 11 institutions in 1 country.

Erwann CariouMedical Intensive Care Unit, CHU de Bordeaux, 33000, Bordeaux, France.
Romain GriffierDepartment of Public Health, University of Bordeaux, 33000, Bordeaux, France.
Arthur OrieuxMedical Intensive Care Unit, CHU de Bordeaux, 33000, Bordeaux, France.
Stein SilvaIntensive Care Unit, University Hospital of Purpan, 31300, Toulouse, France.
Stanislas FaguerIntensive Care Unit, Department of Nephrology and Organ Transplantation, Centre for Rare Renal Diseases, University Hospital of Toulouse, 31000, Toulouse, France.
Thierry SeguinIntensive Care Unit, University Hospital of Rangeuil, 31000, Toulouse, France.
Saad NseirDepartment of Intensive Care Medicine, Critical Care Center, CHU of Lille, 59000, Lille, France.
Emmanuel CanetMedical Intensive Care Unit, Nantes University Hospital, 44000, Nantes, France.
Arnaud DesclauxInfectious and Tropical Diseases Department, CHU Bordeaux, 33000, Bordeaux, France.
Bertrand SouweineMedical Intensive Care Unit, Gabriel-Montpied University Hospital, 63000, Clermont-Ferrand, France.
Kada KloucheMedical Intensive Care Unit, CHU Montpellier, 34000, Montpellier, France.
Olivier GuissetMedical Intensive Care Unit, CHU de Bordeaux, 33000, Bordeaux, France.
Jerome PillotIntensive Care Unit, Hôpital Saint-Léon, Centre Hospitalier de la Côte Basque, 64100, Bayonne, France.
Walter PicardIntensive Care Unit, Centre Hospitalier de Pau, 64000, Pau, France.
Tahar SaghiIntensive Care Unit, Polyclinique Bordeaux Nord Aquitaine, 33000, Bordeaux, France.
Pierre DelobelInfectious and Tropical Diseases Department, CHU Toulouse, 31000, Toulouse, France.
Didier GrusonMedical Intensive Care Unit, CHU de Bordeaux, 33000, Bordeaux, France.
Renaud Prevel *Medical Intensive Care Unit, CHU de Bordeaux, 33000, Bordeaux, France.
Alexandre Boyer *Medical Intensive Care Unit, CHU de Bordeaux, 33000, Bordeaux, France. alexandre.boyer@chu-bordeaux.fr.ORCID http://orcid.org/0000-0003-4384-8872
Inserm · FRCentre Hospitalier Universitaire de Bordeaux · FRUniversité de Bordeaux · FRCentre Hospitalier de la Côte Basque · FRCentre Hospitalier De Pau · FRCentre Hospitalier Universitaire de Lille · FRCentre Hospitalier Universitaire de Nantes · FRHôpital Rangueil · FRPolyclinique Bordeaux Nord Aquitaine · FRUnité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes · FRUniversité Toulouse III - Paul Sabatier · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe rise in antimicrobial resistance is a global threat responsible for about 33,000 deaths in 2015 with a particular concern for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and has led to a major increase in the use of carbapenems, last-resort antibiotics.

methodsIn this retrospective propensity-weighted multicenter observational study conducted in 11 ICUs, the purpose was to assess the efficacy of non carbapenem regimen (piperacillin-tazobactam (PTZ) + aminoglycosides or 3rd-generation cephalosporin (3GC) + aminoglycosides) as empiric therapy in comparison with carbapenem in extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) urinary septic shock. The primary outcome was Day-30 mortality.

resultsAmong 156 patients included in this study, 69 received a carbapenem and 87 received non carbapenem antibiotics as empiric treatment. Baseline clinical characteristics were similar between the two groups. Patients who received carbapenem had similar Day-30 mortality (10/69 (15%) vs 6/87 (7%), OR = 1.99 [0.55; 5.34] p = 0.16), illness severity, resolution of septic shock, and ESBL-E infection recurrence rates than patients who received an empiric non carbapenem therapy. The rates of secondary infection with C. difficile were comparable.

conclusionsIn ESBL-E urinary septic shock, empiric treatment with a non carbapenem regimen, including systematically aminoglycosides, was not associated with higher mortality, compared to a carbapenem regimen.

Indexed as

AminoglycosidesAntimicrobial resistanceExtended-spectrum β-lactamase-producing EnterobacteralesNon carbapenem β-lactam therapySeptic shockUrinary tract infection

Identifiers

PMID36959425
PMCPMC10036246
OpenAlexW4360813900

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read90
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.