Pilot Randomised Controlled Trial of Meropenem versus Piperacillin-Tazobactam for Definitive Treatment of Bloodstream Infections caused by AmpC beta-lactamase producing Enterobacter spp., Citrobacter freundii, Morganella morganii, Providencia spp. or Serratia spp.

The University of Queensland Centre for Clinical Research0 个研究点目标入组 100 人开始时间: 2014年11月17日最近更新: 2020年1月13日

适应症

试验速览

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•a.Bloodstream infection with Enterobacter spp., Serratia marcescens, Providencia spp., Morganella morganii or Citrobacter freundii (i.e. likely AmpC-producer), and susceptibility to 3rd generation cephalosporins (i.e. ceftriaxone, cefotaxime or ceftazidime), meropenem and piperacillin-tazobactam from at least one blood culture draw. This will be determined in accordance with laboratory methods and susceptibility breakpoints defined by protocols used in the recruiting site laboratories.
•b.No more than 72 hours has elapsed since the first positive blood culture collection.
•c.Patient is aged 18 years and over (>=21y in Singapore).

•a. Patient not expected to survive more than 4 days
•b. Patient allergic to a penicillin or a carbapenem
•c. Patient with significant polymicrobial bacteraemia (that is, a Gram positive skin contaminant in one set of blood cultures is not regarded as significant polymicrobial bacteraemia).
•d. Treatment is not with the intent to cure the infection (that is, palliative care is an exclusion).
•e. Pregnancy or breast-feeding.
•f. Use of concomitant antimicrobials in the first 4 days after enrolment with known activity against Gram-negative bacilli (except trimethoprim/sulphamethoxazole may be continued as Pneumocystis prophylaxis).
•g. Likely source to be from (proven or suspected at the time of randomisation) the central nervous system, e.g. brain abscess, post-surgical meningitis, shunt infection (due to concerns over CNS penetration of piperacillin/tazobactam)

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