Treating infections caused by carbapenemase-producing Enterobacteriaceae.


Journal Article (Review)

Carbapenemase-producing Enterobacteriaceae (CPE) have spread worldwide, causing serious infections with increasing frequency. CPE are resistant to almost all available antibiotics, complicating therapy and limiting treatment options. Mortality rates associated with CPE infections are unacceptably high, indicating that the current therapeutic approaches are inadequate and must be revised. Here, we review 20 clinical studies (including those describing the largest cohorts of CPE-infected patients) that provided the necessary information regarding isolate and patient characteristics and treatment schemes, as well as a clear assessment of outcome. The data summarized here indicate that treatment with a single in vitro active agent resulted in mortality rates not significantly different from that observed in patients treated with no active therapy, whereas combination therapy with two or more in vitro active agents was superior to monotherapy, providing a clear survival benefit (mortality rate, 27.4% vs. 38.7%; p <0.001). The lowest mortality rate (18.8%) was observed in patients treated with carbapenem-containing combinations.

Full Text

Cited Authors

  • Tzouvelekis, LS; Markogiannakis, A; Piperaki, E; Souli, M; Daikos, GL

Published Date

  • September 2014

Published In

Volume / Issue

  • 20 / 9

Start / End Page

  • 862 - 872

PubMed ID

  • 24890393

Pubmed Central ID

  • 24890393

Electronic International Standard Serial Number (EISSN)

  • 1469-0691

International Standard Serial Number (ISSN)

  • 1198-743X

Digital Object Identifier (DOI)

  • 10.1111/1469-0691.12697


  • eng