2015
DOI: 10.1128/aac.00701-15
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Multicenter Retrospective Study of Cefmetazole and Flomoxef for Treatment of Extended-Spectrum-β-Lactamase-Producing Escherichia coli Bacteremia

Abstract: . Adult patients treated for E. coli bacteremia in four hospitals were retrospectively evaluated. The 30-day mortality rates in patients belonging to the ESBL-CF, ESBL-carbapenem, and non-ESBL-CF groups were compared as 2 (empirical and definitive therapy) cohorts. The adjusted hazard ratios (aHRs) for mortality were calculated using Cox regression models with weighting according to the inverse probability of propensity scores for receiving CF or carbapenem treatment.

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Cited by 101 publications
(74 citation statements)
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“…Unfortunately, clinical data evaluating cephamycins for ESBL infections are scarce, and data comparing the relative efficacy of the various cephamycins are virtually nonexistent. Existing observational studies comparing cephamycins and carbapenems are plagued by the inherent limitations of observational studies-most notably confounding by indication-as well as small sample sizes (Table 2) [15][16][17][18][19][20]. Only 1 of these studies showed improved outcomes among ESBL-infected patients treated with carbapenems compared with cephamycins, while the others could not detect differences [18] (Table 3).…”
Section: Cephamycinsmentioning
confidence: 99%
“…Unfortunately, clinical data evaluating cephamycins for ESBL infections are scarce, and data comparing the relative efficacy of the various cephamycins are virtually nonexistent. Existing observational studies comparing cephamycins and carbapenems are plagued by the inherent limitations of observational studies-most notably confounding by indication-as well as small sample sizes (Table 2) [15][16][17][18][19][20]. Only 1 of these studies showed improved outcomes among ESBL-infected patients treated with carbapenems compared with cephamycins, while the others could not detect differences [18] (Table 3).…”
Section: Cephamycinsmentioning
confidence: 99%
“…Among ␤-lactam alternatives to carbapenems for the treatment of severe infections due to ESBL and OXA-1 producers, cephamycins (32) and temocillin are the most promising antibiotics. However, treatment of ESBL-producing K. pneumoniae by cefoxitin was associated with emergence of porin-deficient resistant mutants responsible for therapeutic failure and human death (33).…”
Section: Discussionmentioning
confidence: 99%
“…16 In Japan, cefmetazole and flomoxef are commercially available cephamycins and are used commonly. 17 As noted here, a few, small studies examined the efficacy of cephamycins against ESBL infection. Ten adult patients with urinary tract infection (UTI) caused by an ESBL-producing Enterobacteriaceae who were treated with cefmetazole had the same treatment effect as those treated with carbapenems.…”
Section: Introductionmentioning
confidence: 99%
“…In severe ESBL‐producing bacterial infection, however, piperacillin/tazobactam is not generally recommended due to the higher mortality rate associated with its use . In Japan, cefmetazole and flomoxef are commercially available cephamycins and are used commonly . As noted here, a few, small studies examined the efficacy of cephamycins against ESBL infection.…”
Section: Introductionmentioning
confidence: 99%