{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:15:26Z","timestamp":1791825326730,"version":"4.3.4"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ertapenem combination therapy has been associated with a faster time to blood culture sterilization in patients with MSSA bacteraemia. However, guidance documents advise avoiding ertapenem in patients with a serum albumin level of &amp;lt;2.5\u2005g\/dL for Gram negative infections given that ertapenem is highly protein bound and patients with hypoalbuminemia may experience suboptimal ertapenem exposures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>This study was a retrospective, multicenter study of consecutive adult patients with MSSA bacteraemia for &amp;gt;48\u2005h who were treated with cefazolin, oxacillin, or nafcillin in combination with ertapenem. Patients with hypoalbuminemia, defined as a serum albumin level of &amp;lt;2.5\u2005g\/dL, were compared to those with normal albumin levels. Patients received ertapenem 1\u2005g every 24\u2005h or 500\u2005mg every 24\u2005h if they had a creatinine clearance below 30\u2005mL\/min. The primary outcome was time from ertapenem administration to negative blood cultures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 109 patients who received ertapenem for MSSA bacteraemia, 100 met the inclusion criteria. Thirty-eight percent were patients who inject drugs and 52% had definitive endocarditis. After propensity score weighting, patients with hypoalbuminemia had a significantly longer time to negative blood cultures compared to patients with normal albumin levels (HR=0.45, 95% CI: 0.27\u20130.72, P\u200a=\u200a0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among patients with persistent MSSA bacteraemia who were treated with ertapenem combination therapy, patients with hypoalbuminemia had a significantly longer time to negative blood cultures. Pharmacokinetic studies are warranted to confirm if these findings are due to drug exposures or the underlying condition of patients with hypoalbuminemia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaf134","type":"journal-article","created":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T10:56:03Z","timestamp":1748688963000},"page":"1823-1827","source":"Crossref","is-referenced-by-count":8,"title":["Impact of hypoalbuminemia on patients receiving ertapenem combination therapy for methicillin-susceptible <i>Staphylococcus aureus<\/i> bacteraemia"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8873-1451","authenticated-orcid":false,"given":"Sunish","family":"Shah","sequence":"first","affiliation":[{"name":"Antibiotic Management Program, University of Pittsburgh Medical Center , Pittsburgh, PA ,","place":["USA"]},{"name":"Department of Pharmacy, University of Pittsburgh Medical Center , Pittsburgh, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd G","family":"Clarke","sequence":"additional","affiliation":[{"name":"Antibiotic Management Program, University of Pittsburgh Medical Center , Pittsburgh, PA ,","place":["USA"]},{"name":"Department of Pharmacy, University of Pittsburgh Medical Center , Pittsburgh, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G K","family":"Balasubramani","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Pittsburgh , Pittsburgh, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyi","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science, University of Pittsburgh , Pittsburgh, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon J","family":"Smith","sequence":"additional","affiliation":[{"name":"Antibiotic Management Program, University of Pittsburgh Medical Center , Pittsburgh, PA ,","place":["USA"]},{"name":"Department of Medicine, University of Pittsburgh , Pittsburgh, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9794-5665","authenticated-orcid":false,"given":"Ryan K","family":"Shields","sequence":"additional","affiliation":[{"name":"Antibiotic Management Program, University of Pittsburgh Medical Center , Pittsburgh, PA ,","place":["USA"]},{"name":"Department of Medicine, University of Pittsburgh , Pittsburgh, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,31]]},"reference":[{"key":"2025070104562670800_dkaf134-B1","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.cmi.2014.08.003","article-title":"Association between hypoalbuminemia and mortality among subjects treated with ertapenem versus other carbapenems: prospective cohort study","volume":"21","author":"Zusman","year":"2015","journal-title":"Clin Microbiol Infect"},{"key":"2025070104562670800_dkaf134-B2","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1016\/j.ijantimicag.2008.10.005","article-title":"Pharmacokinetics of once-daily dosing of ertapenem in critically ill patients with severe sepsis","volume":"33","author":"Brink","year":"2009","journal-title":"Int J Antimicrob Agents"},{"key":"2025070104562670800_dkaf134-B3","doi-asserted-by":"publisher","first-page":"ciae403","DOI":"10.1093\/cid\/ciae403","article-title":"Infectious Diseases Society of America 2024 guidance on the treatment of antimicrobial-resistant Gram-negative infections","volume":"7","author":"Tamma","year":"2024","journal-title":"Clin Infect Dis"},{"key":"2025070104562670800_dkaf134-B4"},{"key":"2025070104562670800_dkaf134-B5","doi-asserted-by":"publisher","first-page":"1990","DOI":"10.1093\/jac\/dkae198","article-title":"Carbapenem combination therapy versus standard of care for persistent methicillin-susceptible Staphylococcus aureus bacteraemia","volume":"79","author":"Shah","year":"2024","journal-title":"J Antimicrob Chemother"},{"key":"2025070104562670800_dkaf134-B6","doi-asserted-by":"publisher","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","article-title":"2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). 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