Propensity Score and Desirability of Outcome Ranking Analysis of Ertapenem for Treatment of Nonsevere Bacteremic Urinary Tract Infections Due to Extended-Spectrum-Beta-Lactamase-Producing in Kidney Transplant Recipients.

Gutiérrez-Gutiérrez, Belén, Pérez-Nadales, Elena, Pérez-Galera, Salvador, Fernández-Ruiz, Mario, Carratalà, Jordi, Oriol, Isabel, Cordero, Elisa, Lepe, José Antonio, Tan, Ban Hock, Corbella, Laura, Paul, Mical, Natera, Alejandra M, David, Miruna D, Montejo, Miguel, Iyer, Ranganathan N, Pierrotti, Ligia Camera, Merino, Esperanza, Steinke, Seema Mehta, Rana, Meenakshi M, Muñoz, Patricia, Mularoni, Alessandra, van Delden, Christian, Grossi, Paolo Antonio, Seminari, Elena María, Gunseren, Filiz, Lease, Erika D, Roilides, Emmanuel, Fortún, Jesús, Arslan, Hande, Coussement, Julien, Tufan, Zeliha Koçak, Pilmis, Benoit, Rizzi, Marco, Loeches, Belén, Eriksson, Britt Marie, Abdala, Edson, Soldani, Fabio, Lowman, Warren, Clemente, Wanessa Trindade, Bodro, Marta, Fariñas, María Carmen, Kazak, Esra, Martínez-Martínez, Luis, Aguado, José María, Torre-Cisneros, Julián, Pascual, Álvaro and Rodríguez-Baño, Jesús (2021) Propensity Score and Desirability of Outcome Ranking Analysis of Ertapenem for Treatment of Nonsevere Bacteremic Urinary Tract Infections Due to Extended-Spectrum-Beta-Lactamase-Producing in Kidney Transplant Recipients. Antimicrobial agents and chemotherapy, 65 (11). e0110221. ISSN 1098-6596. This article is available to all UHB staff and students using a UHB Athens Account. Register for Athens here-http://openathens.nice.org.uk/

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Abstract

There are scarce data on the efficacy of ertapenem in the treatment of bacteremia due to extended-spectrum-beta-lactamase (ESBL)-producing (ESBL-E) in kidney transplant (KT) recipients. We evaluated the association between treatment with ertapenem or meropenem and clinical cure in KT recipients with nonsevere bacteremic urinary tract infections (B-UTI) caused by ESBL-E. We performed a registered, retrospective, international (29 centers in 14 countries) cohort study (INCREMENT-SOT, NCT02852902). The association between targeted therapy with ertapenem versus meropenem and clinical cure at day 14 (the principal outcome) was studied by logistic regression. Propensity score matching and desirability of outcome ranking (DOOR) analyses were also performed. A total of 201 patients were included; only 1 patient (treated with meropenem) in the cohort died. Clinical cure at day 14 was reached in 45/100 (45%) and 51/101 (50.5%) of patients treated with ertapenem and meropenem, respectively (adjusted OR 1.29; 95% CI 0.51 to 3.22;  = 0.76); the propensity score-matched cohort included 55 pairs (adjusted OR for clinical cure at day 14, 1.18; 95% CI 0.43 to 3.29;  = 0.74). In this cohort, the proportion of cases treated with ertapenem with better DOOR than with meropenem was 49.7% (95% CI, 40.4 to 59.1%) when hospital stay was considered. It ranged from 59 to 67% in different scenarios of a modified (weights-based) DOOR sensitivity analysis when potential ecological advantage or cost was considered in addition to outcome. In conclusion, targeted therapy with ertapenem appears as effective as meropenem to treat nonsevere B-UTI due to ESBL-E in KT recipients and may have some advantages.

Item Type: Article
Additional Information: This article is available to all UHB staff and students using a UHB Athens Account. Register for Athens here-http://openathens.nice.org.uk/
Subjects: QW Microbiology. Immunology
WB Practice of medicine
WC Communicabable diseases
Divisions: Clinical Support > Immunology
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Depositing User: Jamie Edgar
Date Deposited: 09 Nov 2021 14:43
Last Modified: 09 Nov 2021 14:43
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4792

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