Impact of the MIC of piperacillin/tazobactam on the outcome for patients with bacteraemia due to Enterobacteriaceae: the Bacteraemia-MIC project

Delgado-Valverde, Mercedes, Torres, Eva, Valiente-Mendez, Adoracion, Almirante, Benito, Gomez-Zorrilla, Silvia, Borrell, Nuria, Corzo, Juan E., Gurgui, Mercedes, Almela, Manuel, Garcia-Alvarez, Lara, Fontecoba-Sanchez, Maria Crus, Martinez-Martinez, Luis, Canton, Rafael, Praena, Julia, Causse, Manuel, Gutierrez-Gutierrez, Belen, Roberts, Jason A., Farkas, Andras, Pascual, Alvaro, Rodriguez-Bano, Jesus, de Cueto, Marina, Planes Reig, Ana Maria, Quintano, Fe Tubau, Pena, Carmen, Galan Otalora, M. Elvira, Alegria, Carlos Ruiz de, Morosini, M. Isabel, Lepe, Jose Antonio, Cisneros, Jose Miguel, Morey, Shawna and Abdul-Aziz, Mohd-Hafiz (2016) Impact of the MIC of piperacillin/tazobactam on the outcome for patients with bacteraemia due to Enterobacteriaceae: the Bacteraemia-MIC project. Journal of Antimicrobial Chemotherapy, 71 2: 521-530. doi:10.1093/jac/dkv362


Author Delgado-Valverde, Mercedes
Torres, Eva
Valiente-Mendez, Adoracion
Almirante, Benito
Gomez-Zorrilla, Silvia
Borrell, Nuria
Corzo, Juan E.
Gurgui, Mercedes
Almela, Manuel
Garcia-Alvarez, Lara
Fontecoba-Sanchez, Maria Crus
Martinez-Martinez, Luis
Canton, Rafael
Praena, Julia
Causse, Manuel
Gutierrez-Gutierrez, Belen
Roberts, Jason A.
Farkas, Andras
Pascual, Alvaro
Rodriguez-Bano, Jesus
de Cueto, Marina
Planes Reig, Ana Maria
Quintano, Fe Tubau
Pena, Carmen
Galan Otalora, M. Elvira
Alegria, Carlos Ruiz de
Morosini, M. Isabel
Lepe, Jose Antonio
Cisneros, Jose Miguel
Morey, Shawna
Abdul-Aziz, Mohd-Hafiz
Title Impact of the MIC of piperacillin/tazobactam on the outcome for patients with bacteraemia due to Enterobacteriaceae: the Bacteraemia-MIC project
Journal name Journal of Antimicrobial Chemotherapy   Check publisher's open access policy
ISSN 1460-2091
0305-7453
Publication date 2016-02-01
Year available 2015
Sub-type Article (original research)
DOI 10.1093/jac/dkv362
Open Access Status Not yet assessed
Volume 71
Issue 2
Start page 521
End page 530
Total pages 10
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Objective: Our objective was to evaluate the impact of low versus borderline MIC of piperacillin/tazobactam on the clinical outcomes of patients with bacteraemia caused by Enterobacteriaceae who were treated with that antimicrobial.

Patients and methods: A prospective observational multicentre cohort study was conducted in 13 Spanish university hospitals. Patients >17 years old with bacteraemia due to Enterobacteriaceae who received empirical piperacillin/tazobactam treatment for at least 48 h were included. Outcome variables were clinical response at day 21, clinical response at end of treatment with piperacillin/tazobactam and all-cause 30 day mortality. Univariate and multivariate logistic regression analyses were performed.

Results: Overall, 275 patients were included in the analysis; 248 (90.2%) in the low MIC group (≤4 mg/L) and 27 (9.8%) in the borderline MIC group (8-16 mg/L). The biliary tract was the most common source of infection (48.4%) and Escherichia coli was the most frequent pathogen (63.3%). Crude 30 day mortality rates were 10.5% and 11.1% for the low MIC group and the borderline MIC group, respectively (relative risk = 1.06, 95% CI = 0.34-3.27, P = 1). Multivariate analysis of failure at day 21 and at end of treatment with piperacillin/tazobactam and 30 day mortality showed no trend towards increased clinical failure or mortality with borderline MICs (OR = 0.96, 95% CI = 0.18-4.88, P = 0.96; OR = 0.47, 95% CI = 0.10-2.26, P = 0.35; OR = 1.48, 95% CI = 0.33-6.68, P = 0.6).

Conclusions: We did not find that higher piperacillin/tazobactam MIC within the susceptible or intermediate susceptibility range had a significant influence on the outcome for patients with bacteraemia due to Enterobacteriaceae.
Q-Index Code C1
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Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
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