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Efficacy of cefoxitin for the treatment of urinary tract infection due to extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates
| Content Provider | SAGE Publishing |
|---|---|
| Author | Senard, Olivia Bouchand, Frédérique Deconinck, Laurene Matt, Morgan Fellous, Lesly Rottman, Martin Perronne, Christian Dinh, Aurélien Davido, Benjamin |
| Copyright Year | 2019 |
| Abstract | Introduction:Cefoxitin has a good in vitro activity and stability in resistance to hydrolysis by extended-spectrum beta-lactamases and is a good candidate for the treatment of urinary tract infection. However, data are scarce regarding its use in clinical practice.Methods:We conducted a retrospective study from September 2014 to November 2017, in a tertiary care hospital in Garches (France). We gathered all prescriptions of cefoxitin for urinary tract infection due to extended-spectrum beta-lactamase isolates. We compared the clinical outcomes between Escherichia coli and Klebsiella pneumoniae extended-spectrum-beta-lactamase-producing isolates after a 90-day follow-up. When available, we assessed whether cefoxitin-based regimen was associated with an emergence of resistance.Results:The treatment of 31 patients with a mean age of 60 ± 18 years was analyzed. We observed a clinical cure of 96.7% (n = 30/31) at day 30 and of 81.2% (n = 13/16) and 85.7% (12/14) at day 90 for extended-spectrum beta-lactamase Escherichia coli and Klebsiella pneumoniae isolates, respectively (p = 0.72). No adverse events were reported. One patient who relapsed carried a Klebsiella pneumoniae isolate that became intermediate to cefoxitin in the follow-up.Conclusion:In a period of major threat with a continuous increase of extended-spectrum beta-lactamase obliging to a policy of carbapenem-sparing regimens, it seems detrimental to deprive physicians of using cefoxitin for extended-spectrum beta-lactamase Enterobacteriaceae for the treatment of urinary tract infection while our data show its efficacy. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/2049936118811053?download=true |
| ISSN | 20499361 |
| Volume Number | 6 |
| Journal | Therapeutic Advances in Infectious Disease (TAI) |
| e-ISSN | 2049937X |
| DOI | 10.1177/2049936118811053 |
| Language | English |
| Publisher | Sage Publications UK |
| Publisher Date | 2018-11-13 |
| Publisher Place | London |
| Access Restriction | Open |
| Rights Holder | © The Author(s), 2019 |
| Subject Keyword | urinary tract infection Escherichia coli Cefoxitin extended-spectrum beta-lactamase Klebsiella pneumoniae |
| Content Type | Text |
| Resource Type | Article |
| Subject | Infectious Diseases Pharmacology (medical) |
