Treatment efficacy and superinfection rates in complicated urinary tract infections treated with ertapenem or piperacillin tazobactam

Authors: MURAT DİZBAY, HASAN SELÇUK ÖZGER, ÖMER KARAŞAHİN, EMİNE FÜSUN KARAŞAHİN

Abstract: Background/aim: In this retrospective study, the efficacy of ertapenem and piperacillin tazobactam was compared in the treatment of complicated urinary tract infections (cUTIs). Treatment responses were also evaluated for both antibiotics. Materials and methods: A total of 230 patients were enrolled in the study. Of these, 170 received ertapenem and 60 received piperacillin-tazobactam. Results: In both groups, urine cultures after 48 h were negative for the initial uropathogen. The frequency of superinfection was 29.4% in the ertapenem group and 8.3% in the piperacillin-tazobactam group over the duration of treatment (P < 0.05). Urinary catheterization increased the superinfection risk 2.88-fold in the ertapenem group and diabetes mellitus increased the risk 8.50-fold in the piperacillin-tazobactam group (CI: 1.44-5.76 and 1.16-62.09, respectively, P < 0.05). The main pathogen isolated from superinfection in the ertapenem group after 48 h was Enterococcus spp. (71.4%). Conclusion: Both ertapenem and piperacillin-tazobactam were effective in the treatment of cUTIs caused by ESBL-producing microorganisms. A high frequency of superinfection in the ertapenem group was the result of Enterococcus and Pseudomonas spp., against which ertapenem is not active. In the presence of urinary catheterization, diabetes mellitus, and urological intervention, patients should be closely monitored for the development of a superinfection, especially patients receiving ertapenem.

Keywords: Complicated urinary tract infection, ertapenem, piperacillin-tazobactam, efficacy, superinfection

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