Extended-Spectrum Cephalosporin Compared to Cefazolin for Treatment of Klebsiella pneumoniae-Caused Liver Abscess
AUTOR(ES)
Cheng, Hsiao-Pei
FONTE
American Society for Microbiology
RESUMO
From January 1995 to May 2000, a total of 107 adults with liver abscess due to Klebsiella pneumoniae admitted at a large medical center in northern Taiwan were reviewed. Patients were considered to have received cefazolin or an extended-spectrum cephalosporin if they received at least 3 days of that antibiotic within the first 5 days of hospitalization. Fifty-nine (55.1%) patients received cefazolin, and 48 (44.9%) patients received an extended-spectrum cephalosporin. The demographic data, clinical features, severities of illness, and rates of early drainage for the two groups were comparable. However, the rates of developing complications for the two groups were significantly different (37.3 versus 6.3%, respectively; P < 0.001). Furthermore, six independent factors preventing severe complications following liver abscess due to K. pneumoniae were identified: normal platelet count, alkaline phosphatase less than 300 U/liter, no gas formation in the abscess, APACHE III score less than 40, use of an extended-spectrum cephalosporin, and early drainage. In conclusion, cefazolin therapy may be suboptimal for patients with liver abscess due to K. pneumoniae despite active in vitro susceptibility. Use of an extended-spectrum cephalosporin and early drainage for patients with liver abscess due to K. pneumoniae are suggested.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=161845Documentos Relacionados
- Insufficient Evidence that Extended-Spectrum Cephalosporins Effectively Prevent Metastatic Infections Related to Klebsiella pneumoniae-Caused Liver Abscess
- Novel, plasmid-encoded, TEM-derived extended-spectrum beta-lactamase in Klebsiella pneumoniae conferring higher resistance to aztreonam than to extended-spectrum cephalosporins.
- Risk factors for bloodstream infections caused by extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae
- Rare Case of Failure by an Automated System To Detect Extended-Spectrum β-Lactamase in a Cephalosporin-Resistant Klebsiella pneumoniae Isolate
- Increased Serum Resistance in Klebsiella pneumoniae Strains Producing Extended-Spectrum β-Lactamases†