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Journal Articles Med Mal Infect Year : 2013

Alternatives to carbapenems in ESBL-producing Escherichia coli infections.


OBJECTIVES: The authors had for objective to assess the activity of a wide panel of antibiotics on extended-spectrum-β-lactamase producing Escherichia coli isolates (ESBL-Ec), because of the sharp increase of their frequency, leading to an increased use of carbapenems. MATERIAL AND METHODS: We selected 100 ESBL-Ec in which ESBLs were identified by PCR and sequencing, between 2009 and 2010. We determined the MICs of amoxicillin-clavulanate, piperacillin-tazobactam, temocillin, mecillinam, cefoxitin, cefotaxime, ceftazidime, aztreonam, tigecycline, nitrofurantoin, and fosfomycin using reference methods. The susceptibility profiles were defined according to EUCAST 2012 recommendations. RESULTS: Fosfomycin, nitrofurantoin, and pivmecillinam were active against more than 90% of isolates and remain excellent choices for the oral treatment of urinary tract infections (UTIs). Temocillin and piperacillin-tazobactam are also good candidates for the treatment of pyelonephritis or bloodstream infections. Only 27, 23, and 8% of isolates were susceptible to ceftazidime, cefepime, and cefotaxime, respectively. CONCLUSION: Our study results prove that in many cases, there are non-carbapenem alternatives for the treatment of ESBL-Ec infections.
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hal-00802661 , version 1 (20-03-2013)



D. Fournier, C. Chirouze, J. Leroy, P. Cholley, D. Talon, et al.. Alternatives to carbapenems in ESBL-producing Escherichia coli infections.. Med Mal Infect, 2013, 43 (2), pp.62-6. ⟨10.1016/j.medmal.2013.01.006⟩. ⟨hal-00802661⟩
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