Empirical cefepime plus vancomycin versus ceftazidime plus vancomycin versus meropenem plus vancomycin in the treatment of healthcare-associated meningitis: results of the multicenter ephesus study

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dc.authorscopusid10340240700
dc.authorscopusid57199151189
dc.authorscopusid8413935700
dc.authorscopusid6504126867
dc.authorscopusid56039759700
dc.authorscopusid57204010130
dc.authorscopusid56556435400
dc.contributor.authorSipahi, Oğuz Reşat
dc.contributor.authorAkyol, Deniz
dc.contributor.authorÖrmen, Bahar
dc.contributor.authorÇicek-Şentürk, Gönül
dc.contributor.authorMermer, Sinan
dc.contributor.authorÖnal, Uğur
dc.contributor.authorAmer, Fatma
dc.date.accessioned2024-08-25T18:52:07Z
dc.date.available2024-08-25T18:52:07Z
dc.date.issued2023
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM).Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018.Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p < 0.05). Microbiological success on Day 3-5, end of treatment (EOT) clinical success (80% vs. 54.8%% vs 57.9%), and overall success (EOT success followed by one-month survival without relapse or reinfection 65% vs. 51.6% vs. 45.3%), EOT all cause mortality (ACM) and day 30 ACM (15% vs. 22.6% vs. 26%) did not differ significantly (p > 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34).Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.en_US
dc.identifier.doi10.1186/s12879-023-08596-z
dc.identifier.issn1471-2334
dc.identifier.issue1en_US
dc.identifier.pmid37770836en_US
dc.identifier.scopus2-s2.0-85172827939en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.urihttps://doi.org/10.1186/s12879-023-08596-z
dc.identifier.urihttps://hdl.handle.net/11454/102838
dc.identifier.volume23en_US
dc.identifier.wosWOS:001078643300003en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherBmcen_US
dc.relation.ispartofBmc Infectious Diseasesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmz20240825_Gen_US
dc.subjectHealthcare-associated meningitisen_US
dc.subjectEmpirical therapyen_US
dc.subjectMulticenter studyen_US
dc.subjectGlycopeptidesen_US
dc.subjectAntibioticsen_US
dc.subjectNosocomial Bacterial-Meningitisen_US
dc.subjectResistant Staphylococcus-Aureusen_US
dc.subjectPractice Guidelinesen_US
dc.subjectClinical-Featuresen_US
dc.subjectManagementen_US
dc.subjectAdultsen_US
dc.subjectVentriculitisen_US
dc.subjectSeriesen_US
dc.titleEmpirical cefepime plus vancomycin versus ceftazidime plus vancomycin versus meropenem plus vancomycin in the treatment of healthcare-associated meningitis: results of the multicenter ephesus studyen_US
dc.typeArticleen_US

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