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Double carbapenem as a rescue strategy for the treatment of severe carbapenemase-producing Klebsiella pneumoniae infections: a two-center, matched case-control study.


ABSTRACT: Recent reports have suggested the efficacy of a double carbapenem (DC) combination, including ertapenem, for the treatment of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) infections. We aimed to evaluate the clinical impact of such a regimen in critically ill patients.This case-control (1:2), observational, two-center study involved critically ill adults with a microbiologically documented CR-Kp invasive infection treated with the DC regimen matched with those receiving a standard treatment (ST) (i.e., colistin, tigecycline, or gentamicin).The primary end point was 28-day mortality. Secondary outcomes were clinical cure, microbiological eradication, duration of mechanical ventilation and of vasopressors, and 90-day mortality. Forty-eight patients treated with DC were matched with 96 controls. Occurrence of septic shock at infection and high procalcitonin levels were significantly more frequent in patients receiving DC treatment (p?

SUBMITTER: De Pascale G 

PROVIDER: S-EPMC5498909 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Double carbapenem as a rescue strategy for the treatment of severe carbapenemase-producing Klebsiella pneumoniae infections: a two-center, matched case-control study.

De Pascale Gennaro G   Martucci Gennaro G   Montini Luca L   Panarello Giovanna G   Cutuli Salvatore Lucio SL   Di Carlo Daniele D   Di Gravio Valentina V   Di Stefano Roberta R   Capitanio Guido G   Vallecoccia Maria Sole MS   Polidori Piera P   Spanu Teresa T   Arcadipane Antonio A   Antonelli Massimo M  

Critical care (London, England) 20170705 1


<h4>Background</h4>Recent reports have suggested the efficacy of a double carbapenem (DC) combination, including ertapenem, for the treatment of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) infections. We aimed to evaluate the clinical impact of such a regimen in critically ill patients.<h4>Methods</h4>This case-control (1:2), observational, two-center study involved critically ill adults with a microbiologically documented CR-Kp invasive infection treated with the DC regimen matched with  ...[more]

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