Clinical evaluation of cefotiam in the treatment of bacteremia caused by Escherichia coli,Klebsiella species,and Proteus mirabilis: A retrospective study |
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| Affiliation: | 1. Department of Pharmacy, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, Japan;2. Department of Infection Control, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, Japan;3. Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, Japan;1. Department of Pharmacy, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto City, Kumamoto, 860-8556, Japan;2. Department of Critical Care Medicine, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto City, Kumamoto, 860-8556, Japan;1. Department of Pharmacy, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, Japan;2. Department of Infection Control, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, Japan;1. Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan;2. Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey;3. Department of Clinical Pathology, Showa University School of Medicine, Tokyo, Japan;4. Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan;5. Pediatric Nephrology, Aichi Children''s Health and Medical Center, Aichi, Japan;6. Division of Central Laboratory, Showa University School of Medicine, Tokyo, Japan;1. Department of Urology, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan;2. Department of Clinical Pharmacotherapy, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan;3. Department of Urology, Asahi Rousai Hospital, Nagoya, Aichi, 488-8585, Japan;1. Urogenital Sub-Committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan;2. The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan;3. Department of Urology, Japan Organization of Occupational Health and Safety, Chugoku Rosai Hospital, Hiroshima, Japan;4. Department of Urology, Hyogo College of Medicine Hospital, Hyogo, Japan;5. Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Hokkaido, Japan;6. Department of Urology, Fujita Health University Hospital, Aichi, Japan;7. Department of Urology, Graduate School of Medicine, Gifu University, Gifu, Japan;8. Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan;9. Department of Urology, The University of Occupational and Environmental Health Japan, Fukuoka, Japan;10. Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan;11. Daiichi Sankyo Co., Ltd, Japan;12. Department of Urology, The Jikei University Katsushika Medical Center, Tokyo, Japan;13. Infection Control Research Center, Kitasato University, Tokyo, Japan;14. Department of Urology, Sapporo Medical University School of Medicine, Hokkaido, Japan;15. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan;p. Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan;q. Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan;r. Department of Urology, The University of Tokyo Hospital, Tokyo, Japan;s. Department of Urology, Nara Medical University, Kashihara, Japan;t. Division of Urology, Kobe University Graduate School of Medicine, Hyogo, Japan;u. Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan;v. Department of Urology, Fuji City General Hospital, Shizuoka, Japan;w. Department of Urology, Gifu Municipal Hospital, Gifu, Japan;x. Department of Urology, Nagoya Ekisaikai Hospital, Aichi, Japan;y. Department of Urology, Kobayashi City Hospital, Miyazaki, Japan;z. Department of Urology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan;11. Department of Urology, Ogaki Municipal Hospital, Gifu, Japan;12. Department of Urology, Munakata Suikokai General Hospital, Fukuoka, Japan;13. Department of Urology, Gifu Prefectural General Medical Center, Gifu, Japan;14. Department of Urology, Kizawa Memorial Hospital, Gifu, Japan;15. Department of Urology, Osaka Red Cross Hospital, Osaka, Japan;16. Department of Urology, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan;17. Department of Urology, Mitoyo General Hospital, Kagawa, Japan;18. Department of Urology, Yodogawa Christian Hospital, Osaka, Japan;19. Department of Urology, Shinko Hospital, Hyogo, Japan;110. Department of Urology, Okayama City Hospital, Okayama, Japan;111. Department of Urology, Red Cross Okayama Hospital, Okayama, Japan;112. Department of Urology, Fukuoka Shin Mizumaki Hospital, Fukuoka, Japan;113. Department of Urology, Kakogawa Central City Hospital, Hyogo, Japan;114. Department of Urology, Saiseikai Chuwa Hospital, Nara, Japan;115. Department of Urology, Tenri Hospital, Nara, Japan;1p. Department of Urology, Takikawa Municipal Hospital, Hokkaido, Japan;1q. Department of Urology, National Hospital Organization Kure Medical Center, Hiroshima, Japan |
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| Abstract: | Bacteremia is often caused by gram-negative bacteria (represented by EKP; Escherichia coli, Klebsiella species, and Proteus mirabilis), and the excessive use of cefazolin, as the first-line antimicrobial in its treatment, has been a source of concern in the emergence of resistant strains. As an antimicrobial, cefotiam may be an alternative to cefazolin; however, little evidence is available for its use in the treatment of bacteremia. The purpose of this non-inferiority study was to retrospectively compare the therapeutic efficacy of cefotiam with some antimicrobials of narrow spectrum (cefazolin, cefmetazole, and flomoxef) in the treatment of EKP-induced bacteremia. The number of patients recruited was 32 in the cefotiam group and 29 in the control group. In the primary endpoint, the survival rate on day 28 for the cefotiam group and the control group was 93.5% and 89.3%, respectively (relative risk at day 28, 1.048; 95% confidence interval, 0.894–1.227). In the secondary end point, treatment success rate in the two groups was 71.9% and 69.0%, respectively (relative risk, 1.042; 95% confidence interval, 0.752–1.445). Intensive care unit admission, low body weight, hypoalbuminemia, and infections unassociated with the urinary tract were identified to be the risk factors responsible for treatment failure. We demonstrated cefotiam may be non-inferior to other antimicrobials of similar spectrum, in terms of survival rate, in EKP-induced bacteremia. |
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| Keywords: | Cefotiam Bacteremia Cefazolin Antimicrobial resistance CI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0035" }," $$" :[{" #name" :" text" ," _" :" confidence interval EKP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0045" }," $$" :[{" #name" :" text" ," $$" :[{" #name" :" italic" ," _" :" Escherichia coli, Klebsiella" },{" #name" :" __text__" ," _" :" species and " },{" #name" :" italic" ," _" :" Proteus mirabilis MIC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0055" }," $$" :[{" #name" :" text" ," _" :" minimum inhibitory concentration qSOFA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0065" }," $$" :[{" #name" :" text" ," _" :" quick sequential organ failure assessment UTI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0075" }," $$" :[{" #name" :" text" ," _" :" urinary tract infection |
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