ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2024
Cefepime versus carbapenems for treatment of AmpC beta-lactamase-producing Enterobacterales bloodstream infections.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Cefepime and Mortality: A Systematic Review and Bayesian Meta-Analysis.JAMA network open · 2026Pooled it
- Pooled it
- Cefepime susceptibility testing in AmpC-hyperproducing Enterobacter cloacae complex: limitations of routine methods and a pragmatic diagnostic approach.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Infectious Spondylodiscitis of Bacterial Causes in Adults: Epidemiology, Pathophysiology, Diagnostic and Treatment Challenges.Microorganisms · 2026Review
- Review
- Real-life evaluation of BioFire® BCID2 and Vitek® REVEALTM for Gram-negative bloodstream infections in critical care.PloS one · 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
- Comparison between cefepime and carbapenem therapy for deep-seated AmpC-producingAntimicrobial agents and chemotherapy · 2025Article
- The lingering legacy of one letter in antimicrobial susceptibility testing.Journal of medical microbiology · 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
- Next-Gen Nano Biosensor Technologies to Monitor Carbapenem Resistance for Personalized Medicine.Indian journal of microbiology · 2025Article
- Evolution of β-Lactam Antibiotic Resistance inMicroorganisms · 2025Review
- Real-world efficacy and safety of cefepime for pediatric community-acquired pneumonia: a propensity score-matched study.Frontiers in cellular and infection microbiology · 2025Article
- Evaluation of the quickmic system in the rapid diagnosis of Gram-negative bacilli bacteremia.Microbiology spectrum · 2024Article
- 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
- Wild-Type AmpC Beta-Lactamase-ProducingDiseases (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCefepime is recommended for treating infections caused by AmpC beta-lactamase-producing Enterobacterales (AmpC-PE), though supporting evidence is limited. Therefore, this study compared outcomes associated with cefepime versus carbapenem therapy for bloodstream infections (BSIs) caused by AmpC-PE after phenotypic exclusion of ESBL-co-producing isolates.
methodsThis retrospective cohort study compared definite cefepime versus carbapenem treatment for AmpC-PE BSI in hospitalized patients of the University Hospital Basel, Switzerland, between 01/2015 and 07/2020. Primary outcomes included in-hospital death, renal impairment and neurologic adverse events; secondary outcomes included length of hospital stay and recurrent infection.
resultsTwo hundred and seventy episodes of AmpC-PE BSI were included, 162, 77 and 31 were treated with a carbapenem, cefepime and other antibiotics, respectively. Patients treated with carbapenems were more likely to be transferred to the ICU on admission and more frequently had central venous catheter as a source of infection. In uni- and multivariable analyses, primary and secondary outcomes did not differ between the two treatment groups, except for more frequent occurrence of neurological adverse events among patients treated with carbapenems and shorter length of hospital stay among survivors treated with cefepime.
conclusionAfter excluding isolates with phenotypic ESBL-co-production, cefepime was not associated with adverse outcomes compared to carbapenems when used to treat BSIs caused by AmpC-PE. Our study provides evidence to support the use of cefepime as a safe treatment strategy for AmpC-PE BSI, particularly in clinically stable patients without initial renal impairment or increased susceptibility to neurological adverse events.
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