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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Cefuroxime compared to piperacillin/tazobactam as empirical treatment of Escherichia coli bacteremia in a low Extended-spectrum beta-lactamase (ESBL) prevalence cohort

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  1. Treatment of candidemia in a nationwide setting: increased survival with primary echinocandin treatment

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  2. Mecillinam for the treatment of acute pyelonephritis and bacteremia caused by Enterobacteriaceae: a literature review

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  1. Comparison of methods for measuring antibiotic consumption in an intensive care unit

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  2. Evaluation of local instillation of antibiotics in infected walled-off pancreatic necrosis

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  3. Mecillinam for the treatment of acute pyelonephritis and bacteremia caused by Enterobacteriaceae: a literature review

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  4. Update from a twelve-year nationwide fungaemia surveillance: increasing intrinsic and acquired resistance causes concern

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Objectives: On January 18, 2010, a part of the capital region of Denmark shifted the empirical treatment of febrile conditions from cefuroxime to piperacillin/tazobactam. We compare empirical treatment with piperacillin/tazobactam versus cefuroxime for Escherichia coli bacteremia with regard to 14 days mortality, in a low prevalence cohort of Extended-spectrum beta-lactamase-producing E. coli. Methods: From January 18, 2010 to December 31, 2012, we conducted a retrospective cohort study including patients with E. coli bacteremia from six university hospitals in Copenhagen, Denmark. Clinical and laboratory information was obtained from a bacteremia research database, including information on comorbidity, and we used Cox proportional hazard analysis to asses all-cause 14 days mortality. Results: A total of 568 patients receiving either cefuroxime (n=377) or piperacillin/tazobactam (n=191) as empirical therapy were included. In the Cox proportional hazard model, cefuroxime treatment was significantly associated with death (mortality rate ratio 3.95, CI 1.12-13.90). Other variables associated with death were health care related infection (MRR 3.20, CI 1.67-6.15), hospital-acquired infection (MRR 2,17, CI 1.02-4.62), admission at intensive care unit (MRR 20.45, 5.31-78.82), and combination therapy with ciprofloxacin (MRR 2.14, CI 0.98-4.68). Conclusion: Empiric cefuroxime treatment of E. coli bacteremia was significantly associated with higher 14 days mortality in comparison with piperacillin/tazobactam.

Original languageEnglish
JournalInfection and Drug Resistance
Volume12
Pages (from-to)1257-1264
Number of pages8
ISSN1178-6973
DOIs
Publication statusPublished - 2019

ID: 57375417