ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
Exploring heterogeneity in antibiotic choices for bloodstream infections caused by AmpC-producing enterobacterales: results from a case-vignette study.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Mapping the Thematic Structure and Evolution of AmpC β-Lactamase Research: A Bibliometric Analysis.Antibiotics (Basel, Switzerland) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe treatment of bloodstream infections (BSIs) caused by AmpC-producing Enterobacterales (AmpC-E) remains controversial, due to limited clinical evidence and variable resistance profiles. Inappropriate antibiotic choices can induce ampC-encoding gene overexpression, leading to increased risk of therapeutic failure. This study aims to explore the current prescribing preferences among infectious disease (ID) physicians, in complex clinical scenarios involving BSIs caused by AmpC-E.
methodsA web-based case-vignette survey was conducted among a purposive sample of senior ID physicians from 10 ID units in Emilia-Romagna Region, northern Italy. Participants responded to 31 vignettes simulating BSIs caused by Enterobacter cloacae (wild-type or derepressed phenotype) or Serratia marcescens (wild-type phenotype), across varied clinical settings. For each scenario, participants selected their preferred antibiotic regimen.
resultsForty-two ID physicians were invited to participate. Cefepime (48.4%) and meropenem (29.0%) were the most prescribed agents, followed by piperacillin-tazobactam (16.1%) and third-generation cephalosporins (3GC) (6.5%). Cefepime was preferred in milder cases, while meropenem in severe infections, particularly with high inoculum or incomplete source control. Considerable heterogeneity in treatment choices was observed, especially for S. marcescens and E. cloacae with wild-type phenotypes. Agreement among clinicians was highest for intensive care admitted patients. Combination therapies were infrequently proposed (8.8% overall), primarily in the setting of intra-abdominal infections with incomplete source control or ventilator-associated pneumonia.
conclusionThis study highlights significant variability in the treatment of AmpC-E BSIs among ID physicians, reflecting clinical uncertainty and lack of high-quality evidence. Further research and updated, context-specific guidelines are needed to harmonize practice and promote optimal antibiotic stewardship.
Indexed as
Identifiers
41045445What OpenQuestion holds
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.