Effect of piperacillin-tazobactam vs. meropenem in <i>E. coli</i> or <i>K. pneumoniae</i> infection

Study results suggest that piperacillin-tazobactam is no more effective than meropenem for treating bloodstream infections (BSIs) caused by ceftriaxone-resistant E. coli or Klebsiella pneumoniae.

Study results suggest that piperacillin-tazobactam is no more effective than meropenem for treating bloodstream infections (BSIs) caused by ceftriaxone-resistant E. coli or Klebsiella pneumoniae. The finding comes from a noninferiority trial involving nearly 400 participants from nine countries, who were randomized to one drug or the other for a period of no less than 4 days and no more than 14. The 30-day all-cause mortality rate, which served as the primary endpoint, was 12.3% for patients in the piperacillin-tazobactam group compared with 3.7% for patients in the meropenem group. Although the researchers had hoped that piperacillin-tazobactam would offer an alternative to treatment with carbapenems, which are implicated in antibiotic resistance, noninferiority of meropenem was not achieved. Therefore, the trial findings do not support piperacillin-tazobactam as an intervention for patients with E. coli or K. pneumoniae BSIs and resistance to ceftriaxone.