Carbapenems Sparing Antibiotics in the Management of Urinary Tract Infections caused by Multidrug Resistant Gram-Negative Organisms - A New Way to Control Growing Incidences of Carbapenem-Resistant Enterobacteriaceae

Author(s): Abdud Samad*, Hassan Harris and Mohammad Amin Mir

Introduction: Urinary tract infections (UTIs) are the most common infection in humans. The retrospective study was aimed to analyze a new AAE (antibiotic adjuvant entity) of ceftriaxone+sulbactam with adjuvant disodium edetate as a carbapenem sparing drug in the management of UTIs caused by Escherichia coli. Methods: A retrospective review of patients treated for UTIs caused by Escherichia coli between January 2014 to April 2015 was conducted. Demographic characteristics, antibiotic therapy, length of hospital stay and clinical and microbiological outcome have been evaluated. Results: Data of 322 patients were reviewed. Of these, 112 patients who are diagnosed with UTI and having culture positive with E. coli were included in the study. Characterization of these isolates indicated that 48.2% were ESBL positive, 11.6% were MBL positive and 49.0% were found to be non ESBL/MBL. In microbiological evaluation, AAE appeared to be the most active drug against E. coli (89.3%) followed by meropenem (62.5%), imipenem plus cilastatin (58.03%) and piperacillin plus tazobactam (52.65%). Clinical success rate was 82.9% in AAE treated patients followed by 76% in meropenem, 71.4% in imipenem plus cilastatin and 63.1% in piperacillin plus tazobactam treated patients. Conclusion: The present study advocates that AAE can be considered as a drug of choice to carbapenem. Overall, this study results indicate approximately 6 to 11.5% superiority of AAE over penems (meropenem and imipenem plus cilastatin) and 19.8% to piperacillin plus tazobactam.

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