ArticleTransboundary and emerging diseases2026
Clinical Outcomes of Penicillin-Based Therapy Compared to Alternative Enterococcal Treatment in Patients With Vancomycin-Susceptible Enterococcal Bloodstream Infections: A Monocentric Cohort Study.
Article in Transboundary and emerging diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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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1 citing paper in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this retrospective cohort study was to evaluate clinical outcomes of penicillin-based therapies (ampicillin, ampicillin/sulbactam, or piperacillin/tazobactam) compared with alternative therapies (glycopeptides, linezolid, or daptomycin) in patients with vancomycin-susceptible enterococcal bloodstream infections (BSIs). Adult patients with a positive blood culture (BC) for a vancomycin-susceptible Enterococcus species were screened from January 2017 to December 2018. Patients who received adequate antibiotic therapy for at least 48 h were enrolled. The primary outcome, 30-day mortality, was compared between patients receiving penicillin-based and those receiving alternative therapies using the Fisher exact test. Secondary outcomes included 90-day mortality, relapse BSI, length of hospital stay (LOS), and potential antibiotic-related adverse events. To identify independent predictors of 30-day mortality, multivariable logistic regression analysis was weighted for ampicillin susceptibility using propensity scores. Of the 150 patients screened, 127 (84.6%) were included in the final analysis. Among them, 36 (28.3%) developed a septic shock. Aminopenicillin-susceptible Enterococcus species (mainly E. faecalis) accounted for 59.1% of bacteremia cases. Sixty-seven (52.1%) patients received a penicillin-based regimen (monotherapy n = 48, combination n = 19), and 60 (47.2%) patients received an alternative regimen. Patients receiving penicillin-based therapy exhibited a lower 30-day mortality rate of 13.4% compared to 40% (p = 0.001) in those receiving alternative treatments. The 90-day mortality rates were reduced (13.4% versus 41.7%), and LOS was shorter (median 21 versus 35 days) for patients with penicillin-based therapy. There was no significant difference in relapse BSI or potential adverse events between the groups (p > 0.05). However, in the multivariable weighted regression model, only septic shock (aOR with 95% CI: 23.53 [1.66; 334.54]) was identified as an independent positive predictor of 30-day mortality. In conclusion, penicillin-based therapy was still an effective and safe treatment but was not associated with an improved survival in a weighted analysis of patients with enterococcal BSI.
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