Effect of incremental tazobactam concentrations on the bactericidal activity of piperacillin against ESBL-producing enterobacterales clinical isolates causing bacteraemia
摘要
We evaluated the activity of piperacillin in relation to increasing tazobactam concentration against ESBL-producing Enterobacterales collected from patients with bacteraemia. Increasing tazobactam concentration (4, 12 or 24 mg/L) exerted a reduction of piperacillin MICs under the clinical breakpoint in a concentration-dependent manner (0%, 60% and 90% of clinical isolates). Also, activity of piperacillin/tazobactam based at higher achievable serum concentrations (123/14 mg/L) is needed to reduce the bacterial growth in 92% of ESBL-producers. Changes in the piperacillin MIC in relation to increasing tazobactam suggest that realtime TDM could be used for driven antimicrobial therapy with piperacillin/tazobactam in BSI due to ESBL strains.