Clinical experience with ertapenem in the treatment of infections of the biliary tract in daily practice in five Spanish hospitals

Abstract

Efficacy of ertapenem in biliary tract infections in daily practice was retrospectively analyzed. Records of patients admitted to five Spanish hospitals (January 2007/February 2011) with biliary infections (cholecystitis/cholangitis) treated with ertapenem for ⩾72 hours were reviewed. A total of 187 patients (mean 63·8±19·3 years, 52·9% males) were identified. Up to 96 (51·3%) were operated, with cholecystectomy (97·9%) and primary laparoscopy approach (75%) as most frequent intervention. Non-operated patients presented higher age (71·0±17·5 vs 56·9±18·5 years; P<0·001), heart insufficiency (11·0 vs 3·1%; P = 0·044) and the Mortality in Emergency Department Sepsis score (2·99±2·26 vs 1·94±2·34; P<0·001); and longer length of stay (10·3±6·6 vs 9·1±7·0; P = 0·005). Mean duration of treatment was 6·89±3·38 days. Overall favourable response was 87·7% (95% CI = 83·0–92·4) at the end of treatment. In the multivariate analysis (P<0·001, R² Cox = 0·10), non-favourable response was associated with Charlson index⩾5 (OR = 18·71; 95% CI: 1·26–278·55; P = 0·034), pericholecystic abscess (OR = 5·30; 95% CI: 1·26–22·37; P = 0·023) and >3 days from symptoms start to admission (OR = 3·02; 95% CI: 1·13–8·04; P = 0·027).

Keywords:

• Ertapenem
• Cholecystitis
• Cholecystectomy
• Laparoscopy
• Endoscopic retrograde cholangiopancreatography
• Bactobilia
• Gallstones
• Multidrug resistant bacteria

We thank P. Yuste and R. Cavanillas for their continuous support during this study.