title: Cefepime Therapy for Cefepime-Susceptible Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Bacteremia.
abstract: The role of cefepime for extended-spectrum β-lactamase (ESBL) bacteremia is unclear if susceptible in vitro. In a propensity score-matched study of patients with ESBL bacteremia, risk of death was 2.87 times higher for patients receiving cefepime compared with carbapenems (95% confidence interval [CI], .88-9.41). We compared 14-day mortality of patients with ESBL bacteremia receiving empiric cefepime versus empiric carbapenem therapy in a propensity score-matched cohort. There was a trend towards increased mortality in the cefepime group (hazard ratio, 2.87; 95% CI, .88-9.41), which enhances the existing literature suggesting that cefepime may be suboptimal for invasive ESBL infections.
authors.affiliation: Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health.
authors.forename: Ruibin
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Cosgrove
authors.affiliation: Division of Infectious Diseases, University Hospital Basel, Switzerland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Tschudin-Sutter
authors.affiliation: Divisions of Infectious Diseases and Epidemiology, Hospital of the University of Pennsylvania, Philadelphia.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Han
authors.affiliation: Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine.
authors.forename: Alison E
authors.initials: AE
authors.lastname: Turnbull
authors.affiliation: Department of Pharmacy, The Johns Hopkins Hospital.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Hsu
authors.affiliation: Department of Pharmacy, The Johns Hopkins Hospital.
authors.forename: Edina
authors.initials: E
authors.lastname: Avdic
authors.affiliation: Division of Medical Microbiology, The Johns Hopkins University School of Medicine.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Carroll
authors.affiliation: Department of Pediatrics, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Pranita D
authors.initials: PD
authors.lastname: Tamma
keywords: ESBL; bacteremia; carbapenem; cefepime; multidrug-resistant organisms