Clinical and microbiological evaluation of temocillin for bloodstream infections with Enterobacterales: a Belgian single-centre retrospective study

Oosterbos, Julie; Schalkwijk, Maaike; Thiessen, Steven; Oris, Els; Coppens, G.; Lagrou, Katrien; Steensels, Deborah

doi:10.1093/jacamr/dlac086

Cited by 7 publications

(2 citation statements)

References 26 publications

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“… 4 There are no differences in the clinical outcome of patients treated with temocillin for infections due to E. coli , K. pneumoniae and P. mirabilis , compared with those involving E. cloacae complex or other cephalosporinase-producing strains. 13 , 18 , 19 Nevertheless, a few isolates of cephalosporinase-producing species were included in these studies. It would seem advisable to conduct further studies on infections other than those of the urinary tract, distinguishing the species of Enterobacterales and adapting the dosage.…”

Section: Discussionmentioning

confidence: 99%

Impact of revised breakpoints on the categorization of susceptibility of Enterobacterales to temocillin

Farfour,

Le Brun,

Degand

et al. 2023

JAC-Antimicrobial Resistance

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Background To harmonize with the EUCAST breakpoints, the French Society of Microbiology introduced a change in the inhibition diameter breakpoint (17 mm versus 20 mm previously) of temocillin. We assessed the impact of the new breakpoints on categorizing susceptibility of Enterobacterales to temocillin. Methods This was a multicentric retrospective study including all Enterobacterales isolates routinely tested for temocillin susceptibility with the disc diffusion method between 1 January 2016 and 31 July 2022 in four centres. Categorization using the breakpoints of 20 mm (French guidelines CA-SFM/EUCAST 2020 v.1.1) and 17 mm (French guidelines CA-SFM/EUCAST 2021 v1.0 and EUCAST guidelines v11.0) was performed. Results Overall, 36 416 Enterobacterales isolates were included. The overall rate of temocillin resistance decreased from 11.3% to 4.7% (relative difference of 58.5%) when using the 17 mm breakpoint instead of the 20 mm breakpoint, respectively. The relative change ranged from −44.0% in Klebsiella aerogenes to −72.7% in Klebsiella oxytoca. The median inhibition diameter was 23 mm (IQR 21–25). The isolates with a diameter of 20 mm appeared overrepresented, whereas those with a diameter of 18 and 19 mm were underrepresented. We therefore reviewed the diameters between 18 and 21 mm of 273 isolates. Thirty-two (11.7%) of them categorized as susceptible at first measure were controlled resistant at second measure. Conclusions The new breakpoint induced a decrease in the rate of isolates categorized as resistant to temocillin, increasing therapeutic choice including for Extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE). We suggest the bias in measuring the inhibition diameter is probably related to the fact that temocillin is considered remarkably stable against broad-spectrum β-lactamases.

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Section: Discussionmentioning

confidence: 99%

Impact of revised breakpoints on the categorization of susceptibility of Enterobacterales to temocillin

Farfour,

Le Brun,

Degand

et al. 2023

JAC-Antimicrobial Resistance

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“…Additionally, it avoids potential exposure to nosocomial pathogens and decreases the expense of hospitalization to complete a prescribed intravenous antibiotic course 9,10 . In this context, the administration of temocillin in OPAT programs is growing, particularly in urinary tract infections caused by resistant Gram negative bacteria 11,12 .…”

Section: Introductionmentioning

confidence: 99%

Stability Study of Temocillin for Outpatient Parenteral Antimicrobial Therapy

Fernández-Rubio¹,

Herrera‐Hidalgo²,

Gil-Navarro³

et al. 2022

Preprint

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Objective: To evaluate the physical and chemical stability of the antibiotic temocillin at the recommended dose for severe infections and contained in infusion bags or elastomeric devices at different temperatures for its use in Outpatient Parenteral Antimicrobial Therapy (OPAT) programs.Method: Solutions of temocillin 12 g/L diluted in 0.9% sodium chloride were stored at 4ºC ± 2ºC, 25°C ± 2°C, 32°C ± 2°C and 37°C ± 2°C for 72 h both in polypropylene infusion bags and in polyisoprene elastomeric pumps. Physical and chemical stability were evaluated at 12, 24, 30 48 and 72 h after manufacturing. The solutions were considered stable if color, clearness and pH remained unchanged and if the percentage of intact drug was ≥90%. Results: There were no observed changes in color or clarity in any of the refrigerated (4°C) samples or in the samples incubated at 25ºC and 32ºC. At 37ºC, an increase in intensity of yellow color was observed at 30, 48 and 72 h in both infusion bags and elastomeric pumps samples. All samples remained within the pH range 6.84–6.06. At 4ºC, 25ºC and 32°C ± 2°C, temocillin attained the stability criteria of ≥90% of the original concentration for the whole experiment in both devices. At 37ºC, temocillin was stable for 24 h but its concentration dropped below 90% from that time point both in the infusion bags and in the elastomeric pumps.Conclusions: According to the data provided in this stability study, temocillin administrated by continuous infusion would be an appropriate candidate for the treatment of patients that can be discharge to complete therapy in an OPAT program.

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Multicenter interlaboratory study of routine systems for the susceptibility testing of temocillin using a challenge panel of multidrug-resistant strains

Deckers,

Bélik,

Denis

et al. 2023

Eur J Clin Microbiol Infect Dis

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Clinical and microbiological evaluation of temocillin for bloodstream infections with Enterobacterales: a Belgian single-centre retrospective study

Cited by 7 publications

References 26 publications

Impact of revised breakpoints on the categorization of susceptibility of Enterobacterales to temocillin

Impact of revised breakpoints on the categorization of susceptibility of Enterobacterales to temocillin

Stability Study of Temocillin for Outpatient Parenteral Antimicrobial Therapy

Multicenter interlaboratory study of routine systems for the susceptibility testing of temocillin using a challenge panel of multidrug-resistant strains

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