{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T09:36:49Z","timestamp":1787996209316,"version":"build-2784847793"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2025,12,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Deep-seated infections caused by AmpC-producing\n                      <jats:italic toggle=\"yes\">Enterobacterales<\/jats:italic>\n                      (AmpC-E) pose challenges due to high bacterial burdens, altered pharmacokinetics, and the inoculum effect. While cefepime and carbapenems are used for bloodstream infections, their comparative effectiveness for deep-seated AmpC-E infections remains uncertain. This retrospective cohort study (2010\u20132023) evaluated adult inpatients with deep-seated infections caused by AmpC-E (\n                      <jats:italic toggle=\"yes\">Enterobacter cloacae<\/jats:italic>\n                      complex,\n                      <jats:italic toggle=\"yes\">Klebsiella aerogenes<\/jats:italic>\n                      , or\n                      <jats:italic toggle=\"yes\">Citrobacter freundii<\/jats:italic>\n                      ). Patients received cefepime or a carbapenem within 48 hours of index culture for \u226572 hours. Definitive therapy (high-dose cefepime or a carbapenem) was administered for \u226570% of the treatment course. The primary outcome was clinical failure, defined as (i) all-cause mortality within 30 days of index culture or (ii) infection recurrence within 30 days after completion of definitive therapy. Pooled logistic regression with inverse probability treatment weighting (IPTW) and time-varying covariates (year of therapy start, time to source control) estimated predictors of failure. Of 480 patients (cefepime\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 243, carbapenem\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 237),\n                      <jats:italic toggle=\"yes\">E. cloacae<\/jats:italic>\n                      complex accounted for 63.9% of infections. Unadjusted 30-day clinical failure rates were similar (14.8% for cefepime vs 11.4% for carbapenem;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.267). After IPTW, carbapenem therapy had lower odds of clinical failure (adjusted odds ratio [aOR], 0.44; 95% confidence interval [CI], 0.29\u20130.83;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.033). Intensive care unit (ICU) admission increased failure odds (aOR, 2.39; 95% CI, 1.70\u20133.35;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001); source control reduced them (aOR, 0.52; 95% CI, 0.40\u20130.68;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.029). Carbapenem therapy is associated with lower adjusted odds of clinical failure than cefepime in deep-seated AmpC-E infections. ICU admission was independently associated with increased odds of clinical failure, while source control was associated with reduced odds of failure.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00928-25","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T12:48:10Z","timestamp":1761914890000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":7,"title":["Comparison between cefepime and carbapenem therapy for deep-seated AmpC-producing\n                    <i>Enterobacterales<\/i>\n                    infections: a propensity-weighted retrospective cohort study"],"prefix":"10.1128","volume":"69","author":[{"given":"Nicole","family":"Slain","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05vvzn852","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Kentucky HealthCare","place":["Lexington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7700-151X","authenticated-orcid":false,"given":"Kristen","family":"Lucas","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02k3smh20","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Kentucky College of Pharmacy","place":["Lexington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4891-8625","authenticated-orcid":true,"given":"Ashlan J.","family":"Kunz Coyne","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02k3smh20","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Kentucky College of Pharmacy","place":["Lexington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens12091125"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz173"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky084"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae403"},{"key":"e_1_3_1_6_2","first-page":"31","article-title":"Antibacterial in vitro activity of fourth generation cephalosporins","volume":"8","author":"Hancock RE","year":"1996","unstructured":"Hancock RE, Bellido F. 1996. 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