{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:02:31Z","timestamp":1790136151249,"version":"4.0.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T00:00:00Z","timestamp":1696636800000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Extended-spectrum \u03b2-lactamase (ESBL)\u2013producing Enterobacterales have become a global concern owing to increased infections, high mortality, and limited antibiotic treatment options. Carbapenems (CPMs) are effective against ESBL-producing Enterobacterales, but their overuse leads to the emergence of multidrug-resistant bacteria. Cefmetazole (CMZ) is effective in vitro; however, its clinical efficacy remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed patients who were treated with CMZ or CPMs for bacteremia caused by ESBL-producing Enterobacterales between 1 April 2014 and 31 September 2022 at Tenri Hospital. The primary outcome measure was 90-day mortality. We also evaluated resistance genes and sequence types of ESBL-producing Enterobacterales.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 156 patients were enrolled in this study. Ninety patients (58%) received CMZ therapy. Patients in the CMZ group were significantly older than those in the CPM group (median [IQR], 79 years [71\u201386] vs 74 years [64\u201383]; P = .001). The severity of the Pitt bacteremia score of the CMZ group was lower than that in the CPM group (0 [0\u20132] vs 2 [0\u20132], P = .042). Six patients (7%) in the CMZ group and 10 (15%) in the CPM group died by day 90 (P = .110). Charlson Comorbidity Index and prevalence of sequence 131 between the groups were statistically insignificant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings suggest that CMZ is a well-tolerated alternative to CPM for treating bacteremia caused by ESBL-producing Enterobacterales.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad502","type":"journal-article","created":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T19:00:22Z","timestamp":1696705222000},"source":"Crossref","is-referenced-by-count":13,"title":["Efficacy and Safety of Cefmetazole for Bacteremia Caused by Extended-Spectrum \u03b2-Lactamase\u2013Producing Enterobacterales vs Carbapenems: A Retrospective Study"],"prefix":"10.1093","volume":"10","author":[{"given":"Eriko","family":"Kashihara","sequence":"first","affiliation":[{"name":"Department of General Internal Medicine, Tenri Hospital , Nara , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1455-6822","authenticated-orcid":false,"given":"Ryuichi Minoda","family":"Sada","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Tenri Hospital , Nara , Japan"},{"name":"Department of Infection Control, Graduate School of Medicine, Osaka University , Osaka , Japan"},{"name":"Department of Transformative Protection to Infectious Disease, Graduate School of Medicine, Osaka University , Osaka , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukio","family":"Tsugihashi","sequence":"additional","affiliation":[{"name":"Medical Home Care Center, Tenri Hospital Shirakawa Branch , Nara , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Obayashi","sequence":"additional","affiliation":[{"name":"Tenri Institute of Medical Research , Nara , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Science, Faculty of Health Care, Tenri University , Tenri , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Clinical Laboratory Medicine, Tenri Hospital , Tenri , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Tenri Hospital , Nara , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Akebo","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Tenri Hospital , Nara , 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