title: Clinical experience with ertapenem in the treatment of infections of the biliary tract in daily practice in five Spanish hospitals.
abstract: Efficacy of ertapenem in biliary tract infections in daily practice was retrospectively analyzed. Records of patients admitted to five Spanish hospitals (January 2007/February 2011) with biliary infections (cholecystitis/cholangitis) treated with ertapenem for ≥72 hours were reviewed. A total of 187 patients (mean 63.8±19.3 years, 52.9% males) were identified. Up to 96 (51.3%) were operated, with cholecystectomy (97.9%) and primary laparoscopy approach (75%) as most frequent intervention. Non-operated patients presented higher age (71.0±17.5 vs 56.9±18.5 years; P<0.001), heart insufficiency (11.0 vs 3.1%; P = 0.044) and the Mortality in Emergency Department Sepsis score (2.99±2.26 vs 1.94±2.34; P<0.001); and longer length of stay (10.3±6.6 vs 9.1±7.0; P = 0.005). Mean duration of treatment was 6.89±3.38 days. Overall favourable response was 87.7% (95% CI = 83.0-92.4) at the end of treatment. In the multivariate analysis (P<0.001, R² Cox = 0.10), non-favourable response was associated with Charlson index≥5 (OR = 18.71; 95% CI: 1.26-278.55; P = 0.034), pericholecystic abscess (OR = 5.30; 95% CI: 1.26-22.37; P = 0.023) and >3 days from symptoms start to admission (OR = 3.02; 95% CI: 1.13-8.04; P = 0.027).
authors.affiliation: Department of General Surgery, Hospital Clínico San Carlos, Madrid, Spain. ajtorresgarcia@gmail.com
authors.forename: Antonio
authors.initials: A
authors.lastname: Torres
authors.forename: Pedro
authors.initials: P
authors.lastname: Llinares
authors.forename: Fernando
authors.initials: F
authors.lastname: Turegano
authors.forename: Elena
authors.initials: E
authors.lastname: Martin-Perez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lobo
authors.forename: Esteban
authors.initials: E
authors.lastname: Martin-Antona
authors.forename: Juan-Jose
authors.initials: JJ
authors.lastname: Granizo
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Aguilar
mesh_terms: D018784:Abdominal Abscess / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002761:Cholangitis / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D002763:Cholecystectomy; D002764:Cholecystitis / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D003131:Combined Modality Therapy / Q000009:adverse effects; D024881:Drug Resistance, Bacterial; D000077727:Ertapenem; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain; D047090:beta-Lactams / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D000077727:Ertapenem