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2016, Cilt 46, Sayı 1, Sayfa(lar) 033-039
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Can Sequential Use of Oral Antibiotics be an Alternative in Patients with Urosepsis Caused by ESBL-Producing Escherichia coli and Klebsiella pneumoniae?
Aziz Ahmad HAMİDİ1, Derya ÖZYİĞİTOĞLU1, İbrahim TUNCER2, Elif AKTAŞ2, Dilek YILDIZ SEVGİ1, Hüseyin ACİNİKLİ3, Mehmet Emin BULUT2, İlyas DÖKMETAŞ1
1Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, İstanbul
2Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Kliniği, İstanbul
3Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, İstanbul
Keywords: ESBL producing enterobacteriaceae, carbapenem treatment, Urosepsis

Objective: The aim of this study was retrospective investigation of the use of non-carbapenem antibiotics as oral sequential therapy in patients with urosepsis caused by extended- spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae isolates.

Material and Methods: Patients included in the study were evaluated in two groups. Group 1 consisted of 14 patients who underwent carbapenem therapy for 14-21 (median: 14) days, while Group 2 consisted of 12 patients who received carbapenem therapy for 3-11 (median: 6) days, followed by oral sequential therapy with ciprofloxacin or trimethoprim-sulfamethoxazole. The clinical features and treatment outcomes of patients in each group were compared.

Results: Patients in both groups were similar in terms of demographic and clinical findings. The causative agent was E. coli in 9 cases while K. pneumoniae was isolated in 17 cases. Clinical improvement was noted for 24 patients while relapse occurred in one case from each group.

Conclusion: As an outcome we think that oral sequential therapy may be effective after carbapenem therapy in patients with urosepsis caused by extended spectrum betalactamase producing bacteria and further evaluation with extended, prospective and randomized studies would be helpful.


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