Cutting back on third-generation cephalosporins might reduce the number of infection-related deaths in critically ill patients, according to a study at a tertiary-care hospital in Beijing, China.
In phase 1, patients with confirmed or suspected gram-negative bacterial infections were treated primarily with third-generation cephalosporins, such as ceftazidim (Fortaz®, GlaxoSmithKline) and ceftriaxone sodium (Rocephalin®, Roche). In phase 2, they received other antibiotics, such as fourth-generation cephalosporins and carbapenems.
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Phase 2 clinical outcomes were better than those in phase 1. Patients’ stays in the intensive-care unit were shorter (17.6 days versus 29.3 days), and they were more likely to survive (16 of 83 [19.3%] vs. 29 of 80 [36.3%]). Mortality rates dropped significantly in patients with pseudomonal and lower respiratory infections.