SynthesisInfection2025
Piperacillin/tazobactam vs. cefepime or carbapenems for the treatment of bloodstream infections due to bacteria producing chromosomal AmpC beta-lactamase: a systematic review and meta-analysis.
Synthesis in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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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.
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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.
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Who cites it
7 citing papers in PubMed.
- Mapping the Thematic Structure and Evolution of AmpC β-Lactamase Research: A Bibliometric Analysis.Antibiotics (Basel, Switzerland) · 2026Article
- Burn Infections and Sepsis: Challenges and Future Prospects of Antibacterial Therapy.Antibiotics (Basel, Switzerland) · 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
- Piperacillin-tazobactam caused post-trauma patient's postoperative leukopenia, hypokalemia, and periodic fever: a case report.International journal of emergency medicine · 2025Article
- Comparison between cefepime and carbapenem therapy for deep-seated AmpC-producingAntimicrobial agents and chemotherapy · 2025Article
- Correlation of OXA-1 and TEM-1 genes with antibiotic resistance to piperacillin/tazobactam in ESBL-producing Enterobacterales: insights from a multi-center analysis.Frontiers in cellular and infection microbiology · 2025Article
- Infection Leading to Breast Abscess Formation in Pregnancy: A Case Report.International medical case reports journal · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe best treatment for bloodstream infections (BSI) due to chromosomal AmpC (c-AmpC) producing Enterobacterales is not clearly defined.
objectivesTo describe the clinical and microbiological outcomes of patients treated with piperacillin/tazobactam, cefepime or carbapenems for bloodstream infections (BSIs) due to c-AmpC beta-lactamase-producing strains. DATA SOURCES: We searched MEDLINE, the Cochrane Library and EMBASE to screen original reports published up to January 2024. STUDY ELIGIBILITY CRITERIA: RCTs and observational studies investigating all-cause mortality, clinical failure, microbiological failure or rate of ADRs of patients treated with piperacillin/tazobactam, cefepime or carbapenems.
participantsPatients with bloodstream infections due to c-AmpC producing bacteria.
interventionsPiperacillin/tazobactam, cefepime or carbapenems as targeted treatment. ASSESSMENT OF RISK OF BIAS: We used the Cochrane Risk of Bias Tool for RCTs, and the Newcastle Ottawa scale for observational studies. METHODS OF DATA SYNTHESIS: We conducted a meta-analysis pooling Risk ratios (RRs) through random effect models.
resultsWe screened 1,720 original reports, and 20 studies (1 RCTs, 1 case-control study, 18 cohort studies) were included in the analysis, for a total of 2,834 patients. When comparing piperacillin/tazobactam with alternative treatments (cefepime or carbapenems), no significant difference in mortality rate was observed between the treatment groups (RR: 1.1; 95% CI: 0.76-1.58, p = 0.61), while an higher rate of microbiological failure (RR: 1.80; 95% CI: 1.15-2.82, p = 0.01) and clinical failure (RR: 1.54; 95% CI: 1.00-2.40, p = 0.05) was observed among patients receiving piperacillin/tazobactam. No difference was observed in microbiological and clinical failure rate among patients treated with cefepime or carbapenems, with a lower mortality rate in those receiving cefepime (RR: 0.74; 95% CI: 0.59-0.94, p = 0.014).
conclusionsCefepime represents an excellent alternative to carbapenems for BSI due to AmpC-producing strains, whereas piperacillin/tazobactam is associated with a higher rate of clinical and microbiological failure. There is an urgent need for randomized clinical trials that aim to define the best carbapenem-sparing strategy in these infections.
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Registered trials
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.