Risk Factors Influencing the Development of Piperacillin-tazobactam and Cefepime-Resistant Gram-Negative Bacteremia in Pediatric Patients
SN Comprehensive Clinical Medicine, cilt.7, sa.1, 2025 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 7 Sayı: 1
- Basım Tarihi: 2025
- Doi Numarası: 10.1007/s42399-025-02171-0
- Dergi Adı: SN Comprehensive Clinical Medicine
- Derginin Tarandığı İndeksler: Scopus, EMBASE
- Anahtar Kelimeler: Antimicrobial resistance, Carbapenem, Cefepime, Gram-negative, Piperacillin-tazobactam
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
Objective: The rise in antimicrobial resistance among Gram-negative bacteria has highlighted the importance of optimizing the use of existing antibiotics. Rational use of piperacillin-tazobactam and cefepime, which are effective against Gram-negative organism, is particularly important for sparing carbapenems. Methods: This retrospective study included pediatric patients aged 1 month to 18 years who developed monomicrobial bacteremia due to Gram-negative bacilli. Predictors of resistance to piperacillin-tazobactam (PTZ), cefepime (CEF), and both PTZ and CEF resistance (PTZ-CEF) were evaluated. Results: A total of 249 episodes of Gram-negative bacteremia were identified. Resistance to PTZ was found to be 54%, CEF resistance was 63.9%, and PTZ-CEF resistance 50.6%. Previous use of carbapenems and colistin within the prior 3 months, as well as admission to the Pediatric Intensive Care Unit (PICU), were associated with resistance to piperacillin-tazobactam and/or cefepime. Conclusion: As PTZ and CEF resistance exceeded 50%, making monotherapy with these agents generally unsuitable for empirical Gram-negative bacteremia treatment. Each healthcare center should conduct its own surveillance and tailor the empirical treatment of Gram-negative bacteremia based on its institutional data.