{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:15:47Z","timestamp":1765700147620,"version":"3.48.0"},"reference-count":28,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,10,21]]},"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Bloodstream infection (BSI) due to extended-spectrum \u03b2-lactamase-producing Gram-negative bacilli (ESBL-GNB) is increasing at an alarming pace worldwide. Although \u03b2-lactam\/\u03b2-lactamase inhibitor (BLBLI) combinations have been suggested as an alternative to carbapenems for the treatment of BSI due to these resistant organisms in the general population, their usefulness for the treatment of BSI due to ESBL-GNB in haematological patients with neutropaenia is yet to be elucidated. The aim of the BICAR study is to compare the efficacy of BLBLI combinations with that of carbapenems for the treatment of BSI due to an ESBL-GNB in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A multinational, multicentre, observational retrospective study. Episodes of BSI due to ESBL-GNB occurring in haematological patients and haematopoietic stem cell transplant recipients with neutropaenia from 1 January 2006 to 31 March 2015 will be analysed. The primary end point will be case-fatality rate within 30\u2005days of onset of BSI. The secondary end points will be 7-day and 14-day case-fatality rates, microbiological failure, colonisation\/infection by resistant bacteria, superinfection, intensive care unit admission and development of adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample size<\/jats:title>\n                    <jats:p>The number of expected episodes of BSI due to ESBL-GNB in the participant centres will be 260 with a ratio of control to experimental participants of 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The protocol of the study was approved at the first site by the Research Ethics Committee (REC) of Hospital Universitari de Bellvitge. Approval will be also sought from all relevant RECs. Any formal presentation or publication of data from this study will be considered as a joint publication by the participating investigators and will follow the recommendations of the International Committee of Medical Journal Editors (ICMJE). The study has been endorsed by the European Study Group for Bloodstream Infection and Sepsis (ESGBIS) and the European Study Group for Infections in Compromised Hosts (ESGICH).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013268","type":"journal-article","created":{"date-parts":[[2017,1,23]],"date-time":"2017-01-23T21:30:56Z","timestamp":1485207056000},"page":"e013268","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical efficacy of \u03b2-lactam\/\u03b2-lactamase inhibitor combinations for the treatment of bloodstream infection due to extended-spectrum \u03b2-lactamase-producing\n                    <i>Enterobacteriaceae<\/i>\n                    in haematological patients with neutropaenia: a study protocol for a retrospective observational study (BICAR)"],"prefix":"10.1136","volume":"7","clinical-trial-number":[{"clinical-trial-number":"nct02176122","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"C","family":"Gudiol","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain"},{"name":"Duran i Reynals Hospital, ICO, L'Hospitalet de Llobregat, Barcelona, Spain"},{"name":"REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Royo-Cebrecos","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain"},{"name":"REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Tebe","sequence":"additional","affiliation":[{"name":"Statistics Advisory Service, Institute of Biomedical Research of Bellvitge, Rovira i Virgili University, L'Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Abdala","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, University of S\u00e3o Paulo, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Akova","sequence":"additional","affiliation":[{"name":"Hacettepe University School of Medicine, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Group, Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), University of Seville\/CSIC\/University Hospitals Virgen del Rocio and Virgen Macarena, Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Maestro-de la Calle","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre\u201d (i+12), \u201c12 de Octubre\u201d University Hospital; 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