In Vitro Activity and Clinical Efficacy of Faropenem against Third-Generation Cephalosporin-Resistant Escherichia coli and Klebsiella pneumoniae

Kazuhiro Ishikawa, Yuki Uehara, Nobuyoshi Mori, Yumiko Mikami, Sayuri Tokioka, Daiki Kobayashi, Hisa Goke, Tatsuya Inukai, Aki Sakurai, Yohei Doi, Sayoko Kawakami, Shizuo Kayama, Motoyuki Sugai, Shigeki Nakamura

Research output: Contribution to journalArticlepeer-review

Abstract

Faropenem (FRPM) is active against extended-spectrum b-lactamase (ESBL)producing Enterobacterales, but evidence for its efficacy is lacking. This study determined the correlation between the susceptibility by disk diffusion method and the MIC of FRPM for third-generation cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae, and the effectiveness of FRPM for the treatment of urinary tract infection (UTI) caused by these two bacteria in a retrospective cohort analysis. Of the 48 third-generation cephalosporin-resistant clinical isolates tested, 44 isolates produced ESBL, and 8 isolates produced AmpC, including 4 isolates produced both ESBL and AmpC. Thirty-seven isolates had an FRPM MIC of #1 mg/L, and seven had an FRPM MIC of 2 mg/L. An FRPM MIC of .2 mg/L was observed with four isolates. In a retrospective cohort analysis, 63 patients with UTI treated with FRPM were identified. All isolates of ESBL-producing E. coli (n = 54) and K. pneumoniae (n = 9) treated with FRPM showed disk diffusion zone diameters larger than 16.0 mm (estimated MIC, 2.2 mg/L). All patients completed the scheduled treatment courses with FRPM, but 28- and 90-day relapses happened in 10 patients (16%) and 16 patients (25%), respectively. No significant risk factors for the 28- and 90-day relapses were found. FRPM can be used according to disk diffusion susceptibility testing in UTI. Further investigations are necessary to assess the clinical breakpoint of FRPM for ESBL-producing Enterobacterales and the candidates most likely to benefit from using FRPM.

Original languageEnglish
JournalAntimicrobial agents and chemotherapy
Volume66
Issue number6
DOIs
Publication statusPublished - 06-2022

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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