Catheter-associated urinary tract infections are one of the most common sources of infection, accounting for up to 40% of health care–associated infections each year in the United States. Extended-spectrum β-lactamase–producing Enterobacteriaceae are frequent causes of urinary tract infections in health care settings. Prevalent use of carbapenems has led to the emergence of carbapenem-resistant Enterobacteriaceae infections, leaving clinicians with few treatment options. Reducing carbapenem use and investigating alternative options for low-severity extended-spectrum β-lactamase infections is imperative to prevent more cases of carbapenem-resistant Enterobacteriaceae. Although carbapenems are the antibiotics of choice for treating extended-spectrum β-lactamase–producing Enterobacteriaceae catheter-associated urinary tract infections, carbapenem-sparing regimens may be appropriate for treating hemodynamically stable patients with low inoculum levels. Moreover, frontline health care providers can initiate efforts to reduce the development of multidrug-resistant organisms by decresing inappropriate antibiotic use during the treatment of catheter-associated asymptomatic bacteruria, avoiding unnecessary catheterizations, and avoiding culturing urine in asymptomatic patients.
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1 October 2017
Pharmacology|
October 01 2017
Reducing Carbapenem Exposure: Extended-Spectrum β-Lactamase Catheter-Associated Urinary Tract Infection Management
Shannon Holt, PharmD, BCPS-AQ ID;
Shannon Holt, PharmD, BCPS-AQ ID
Shannon Holt is an assistant professor of clinical education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and a clinical pharmacist specialist, infectious disease, Department of Pharmacy, WakeMed Health & Hospitals, Raleigh, North Carolina. Mollie Grant is a critical care pharmacy specialist, WakeMed Health & Hospitals, Raleigh, North Carolina. Kelly A. Thompson-Brazill is an assistant professor, Georgetown University School of Nursing and Health Studies, Washington, DC.
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Mollie Grant, PharmD, BCPS, BCCCP;
Mollie Grant, PharmD, BCPS, BCCCP
Shannon Holt is an assistant professor of clinical education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and a clinical pharmacist specialist, infectious disease, Department of Pharmacy, WakeMed Health & Hospitals, Raleigh, North Carolina. Mollie Grant is a critical care pharmacy specialist, WakeMed Health & Hospitals, Raleigh, North Carolina. Kelly A. Thompson-Brazill is an assistant professor, Georgetown University School of Nursing and Health Studies, Washington, DC.
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Kelly A. Thompson-Brazill, RN, DNP, ACNP-BC, CCRN-CSC
Shannon Holt is an assistant professor of clinical education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and a clinical pharmacist specialist, infectious disease, Department of Pharmacy, WakeMed Health & Hospitals, Raleigh, North Carolina. Mollie Grant is a critical care pharmacy specialist, WakeMed Health & Hospitals, Raleigh, North Carolina. Kelly A. Thompson-Brazill is an assistant professor, Georgetown University School of Nursing and Health Studies, Washington, DC.
Corresponding author: Kelly A. Thompson-Brazill, rn, dnp, acnp-bc, ccrn-csc, fccm, Georgetown University School of Nursing and Health Studies, 3700 Reservoir Rd NW, Washington, DC 20057 (email: [email protected]).
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Crit Care Nurse (2017) 37 (5): 78–84.
Citation
Shannon Holt, Mollie Grant, Kelly A. Thompson-Brazill; Reducing Carbapenem Exposure: Extended-Spectrum β-Lactamase Catheter-Associated Urinary Tract Infection Management. Crit Care Nurse 1 October 2017; 37 (5): 78–84. doi: https://doi.org/10.4037/ccn2017648
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