MERINO

Piperacillin-Tazobactam vs Meropenem for ESBL Bacteraemia

Patient / Population Intervention / Exposition Comparaison Critère de jugement

In 391 patients with ceftriaxone-non-susceptible E. coli or K. pneumoniae bacteraemia, piperacillin-tazobactam increased 30-day mortality compared with meropenem.

391

Schéma

Open-label non-inferiority RCT

Critère

30-day all-cause mortality

Pertinence

Résultat30-day mortality 12.3% (23/187) vs 3.7% (7/191); risk difference 8.6% (1-sided 97.5% CI −∞ to 14.5%), P=.90 for noninferiority — noninferiority not met.

Harris PNA, et al. JAMA. 2018;320(10):984-994. 10.1001/jama.2018.12163

Discussion et critique

Definitive evidence to use carbapenems for ESBL bloodstream and intra-abdominal infection — piperacillin-tazobactam is not equivalent.