The rise in antimicrobial resistance is a global threat responsible for about 33,000 deaths in 2015 with a particular concern for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and has led to a major increase in the use of carbapenems, last-resort antibiotics.In this retrospective propensity-weighted multicenter observational study conducted in 11 ICUs, the purpose was to assess the efficacy of non carbapenem regimen (piperacillin-tazobactam (PTZ) + aminoglycosides or 3rd-generation cephalosporin (3GC) + aminoglycosides) as empiric therapy in comparison with carbapenem in extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) urinary septic shock. The primary outcome was Day-30 mortality.Among 156 patients included in this study, 69 received a carbapenem and 87 received non carbapenem antibiotics as empiric treatment. Baseline clinical characteristics were similar between the two groups. Patients who received carbapenem had similar Day-30 mortality (10/69 (15%) vs 6/87 (7%), OR = 1.99 [0.55; 5.34] p = 0.16), illness severity, resolution of septic shock, and ESBL-E infection recurrence rates than patients who received an empiric non carbapenem therapy. The rates of secondary infection with C. difficile were comparable.In ESBL-E urinary septic shock, empiric treatment with a non carbapenem regimen, including systematically aminoglycosides, was not associated with higher mortality, compared to a carbapenem regimen.

Carbapenem

Regimen

Tazobactam

Empiric therapy

Piperacillin/tazobactam

10.1186/s13613-023-01106-z

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Citations (2)

Le rapport protéinurie/créatinurie améliore nettement la discrimination SHU/PTT à l’ère des thérapies ciblées : un test simple et performant

Néphrologie & Thérapeutique (2019)

Laure Burguet Benjamin Taton Mathilde Prézelin-Reydit Sébastien Rubin Walter Picard

10.1016/j.nephro.2019.07.037

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Citations (1)

Author response for "Symptom‐based case definitions for COVID‐19: Time and geographical variations for detection at hospital admission among 260,000 patients"

Joaquín Baruch Amanda Rojek Christiana Kartsonaki Bharath Kumar Tirupakuzhi Vijayaraghavan Bronner P. Gonçalves

10.1111/irv.13039/v2/response1

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Pressure-Support Ventilation vs T-Piece During Spontaneous Breathing Trials Before Extubation Among Patients at High Risk of Extubation Failure

CHEST Journal (2020)

Arnaud W. Thille Rémi Coudroy Mai-Anh Nay Arnaud Gacouin Alexandre Demoule

Spontaneous breathing trial

Pressure support ventilation

10.1016/j.chest.2020.04.053

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Citations (21)

Target-Controlled Dosing of Remifentanil During Cardiac Surgery Reduces Postoperative Hyperalgesia

Journal of Cardiothoracic and Vascular Anesthesia (2011)

Philippe Richebé O. Pouquet Srdjan Jelačić Sonya Mehta Joachim Calderon

Clinical endpoint

10.1053/j.jvca.2011.03.185

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Citations (75)

Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry

Research and Practice in Thrombosis and Haemostasis (2023)

Matthew Griffee Patrı́cia T. Bozza Luis Felipe Reyes Devin Eddington Dorothea Rosenberger

10.1016/j.rpth.2023.102142

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Citations (3)

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Infection (2021)

Sheryl Ann Abdukahil Ryuzo Abe Laurent Abel Lara Absil Andrew Acker

Abstract Background The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men.

10.1007/s15010-021-01599-5

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Citations (74)

Comparison of 8 versus 15 days of antibiotic therapy for Pseudomonas aeruginosa ventilator-associated pneumonia in adults: a randomized, controlled, open-label trial

Intensive Care Medicine (2022)

Adrien Bouglé Sophie Tuffet Laura Federici Marc Léone Antoine Monsel

Ventilator-associated Pneumonia

Clinical endpoint

Bacterial pneumonia

10.1007/s00134-022-06690-5

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Citations (65)