caa a22 4500 606157409 CHVBK 20210128100613.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s10096-015-2406-x doi (NATIONALLICENCE)springer-10.1007/s10096-015-2406-x Amoxicillin plus temocillin as an alternative empiric therapy for the treatment of severe hospital-acquired pneumonia: results from a retrospective audit [Elektronische Daten] [H. Habayeb, B. Sajin, K. Patel, C. Grundy, A. Al-Dujaili, S. Van de Velde] A formulary decision was made at a large provider of acute hospital services in Surrey to replace piperacillin/tazobactam with amoxicillin+temocillin for the empiric treatment of severe hospital-acquired pneumonia. This decision was made because the use of broad-spectrum-β-lactam antibiotics is a known risk factor for Clostridium difficile infection (CDI) and for the selection of resistance. After the antibiotic formulary was changed, a retrospective audit was conducted to assess the effect of this change. Data from patients hospitalised between January 2011 and July 2012 for severe hospital-acquired pneumonia and treated empirically with piperacillin/tazobactam or amoxicillin+temocillin were reviewed retrospectively. Clinical characteristics of patients, data related to the episode of pneumonia, clinical success and incidence of significant diarrhoea and CDI were analysed. One hundred ninety-two episodes of severe hospital-acquired pneumonia in 188 patients were identified from hospital records. Ninety-eight patients received piperacillin/tazobactam and 94 amoxicillin+temocillin. At baseline, the two treatment groups were comparable, except that more patients with renal insufficiency were treated with piperacillin/tazobactam. Clinical success was comparable (80 versus 82%; P = 0.86), but differences were observed between piperacillin/tazobactam and amoxicillin+temocillin for the rates of significant diarrhoea (34 versus 4%, respectively; P < 0.0001) and for CDI (7 versus 0%, respectively; P < 0.0028). This preliminary study suggests that the combination amoxicillin+temocillin is a viable alternative to piperacillin/tazobactam for the treatment of severe hospital-acquired pneumonia. This combination appears to be associated with fewer gastrointestinal adverse events. Further studies are needed to evaluate the place of amoxicillin+temocillin as empiric treatment of severe hospital-acquired pneumonia. The Author(s), 2015 Habayeb H. Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, KT16 0PZ, Chertsey, Surrey, UK aut Sajin B. Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, KT16 0PZ, Chertsey, Surrey, UK aut Patel K. Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, KT16 0PZ, Chertsey, Surrey, UK aut Grundy C. Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, KT16 0PZ, Chertsey, Surrey, UK aut Al-Dujaili A. Royal Berkshire Hospital NHS Foundation Trust, Craven Road, RG1 5AN, Reading, UK aut Van de Velde S. Eumedica s.a., Chemin de Nauwelette 1, 7170, Manage, Belgium aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/8(2015-08-01), 1693-1699 0934-9723 34:8<1693 2015 34 10096 https://doi.org/10.1007/s10096-015-2406-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2406-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Habayeb H. Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, KT16 0PZ, Chertsey, Surrey, UK aut NATIONALLICENCE 700 1- Sajin B. Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, KT16 0PZ, Chertsey, Surrey, UK aut NATIONALLICENCE 700 1- Patel K. Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, KT16 0PZ, Chertsey, Surrey, UK aut NATIONALLICENCE 700 1- Grundy C. Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, KT16 0PZ, Chertsey, Surrey, UK aut NATIONALLICENCE 700 1- Al-Dujaili A. Royal Berkshire Hospital NHS Foundation Trust, Craven Road, RG1 5AN, Reading, UK aut NATIONALLICENCE 700 1- Van de Velde S. Eumedica s.a., Chemin de Nauwelette 1, 7170, Manage, Belgium aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/8(2015-08-01), 1693-1699 0934-9723 34:8<1693 2015 34 10096