{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T01:46:10Z","timestamp":1782524770006,"version":"3.54.5"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:00:00Z","timestamp":1613260800000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>With increasing frequency of resistant Gram-negative bacteria, temocillin has potential utility in reducing carbapenem use. The 2020 EUCAST guideline changes temocillin breakpoints and reclassifies isolates with an MIC of 0.001\u201316\u2009mg\/L as \u2018susceptible, increased exposure\u2019 necessitating 6\u2009g\/day rather than the previous 4\u2009g\/day, associated with significant cost implications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We explore the clinical utility and treatment failure rate of temocillin at 4\u2009g\/day dosing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All adult inpatient electronic prescriptions of temocillin (3\u2009days or greater) from March 2016 to October 2019 were retrieved using a clinical decision support system (ICNET\u00ae). Treatment success was defined as survival, no switch to broad-spectrum agent for the same indication and no subsequent recrudescence of infection, occurring within 30\u2009days.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Temocillin was used in 205 eligible patient-episodes, median age 79\u2009years (IQR : 71\u201387\u2009years), 42.4% female. Median temocillin course length was 5.9\u2009days (IQR : 4.6\u20137.8\u2009days). Indications for use: urinary tract infection (UTI) (n\u2009=\u2009141), pneumonia (n\u2009=\u200953), other (n\u2009=\u200911). In total, 144 (70.2%) patients had targeted treatment; 74 (36.1%) against Escherichia coli, 70 (34.4%) other Enterobacterales. A total of 130 (63%) patients received 4\u2009g\/day; the remaining patients had reduced renal function with dosing in accordance with guidance. Overall temocillin treatment success was 79.5%; highest when used to treat UTI 85.8% (versus 67.9% in respiratory infections, P\u2009=\u20090.008). Empirical treatment demonstrated 82.0% (50\/61) success [versus 78.5% (113\/144) among targeted treatment, P\u2009=\u20090. 71].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Temocillin at 4\u2009g\/day is an effective and safe alternative in treating patients with Gram-negative infections, but should be considered in the context of patient age and comorbidities. Increased dosing or alternate strategies may be indicated when the infection is not of a urinary source.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlab005","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T04:17:03Z","timestamp":1610511423000},"source":"Crossref","is-referenced-by-count":20,"title":["Clinical outcomes of temocillin use for invasive Enterobacterales infections: a single-centre retrospective analysis"],"prefix":"10.1093","volume":"3","author":[{"given":"Katie L","family":"Heard","sequence":"first","affiliation":[{"name":"Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"Killington","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabeela","family":"Mughal","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK"},{"name":"North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road. London W6 8RF, UK"},{"name":"National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke S P","family":"Moore","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK"},{"name":"North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road. London W6 8RF, UK"},{"name":"National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Hughes","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,14]]},"reference":[{"key":"2021052713040660200_dlab005-B1","doi-asserted-by":"crossref","first-page":"pii=19044","DOI":"10.2807\/ese.13.47.19044-en","article-title":"Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe","volume":"13","author":"Coque","year":"2008","journal-title":"Euro 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injection (ZTI-01) versus piperacillin-tazobactam for the treatment of complicated urinary tract infection including acute pyelonephritis: ZEUS, a Phase 2\/3 randomized trial","volume":"69","author":"Kaye","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2021052713040660200_dlab005-B13","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1093\/cid\/ciw378","article-title":"Ceftazidime-avibactam versus doripenem for the treatment of complicated urinary tract infections, including acute pyelonephritis: RECAPTURE, a Phase 3 randomized trial program","volume":"63","author":"Wagenlehner","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2021052713040660200_dlab005-B14","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1016\/S1473-3099(18)30554-1","article-title":"Cefiderocol versus imipenem-cilastatin for the treatment of complicated urinary tract infections caused by Gram-negative uropathogens: a phase 2, randomised, double-blind, non-inferiority 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