Merino Trial Ampc
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Merino trial ampc. Previously randomised in the merino 3 trial or concurrently enrolled in another therapeutic antibiotic clinical trial blood culture isolate with in vitro resistance to either meropenem or ceftolozane tazobactam known either at time of enrolment or during the course of study treatment in which case the participant will be withdrawn. Merino trial this supplement contains the following items. Randomised controlled trial of meropenem versus piperacillin tazobactam for definitive treatment of bloodstream infections due to ceftriaxone non susceptible escherichia coliand klebsiella spp.
A total of 23 of 187 patients 123 randomized to piperacillin tazobactam. 478 women who were randomized appropriately received at least 1 dose of study drug and were included in the primary analysis population 378 997 completed the trial and were assessed for the primary outcome. Original protocol final protocol summary of changes.
The merino trial is the first randomized controlled trial to evaluate piperacillintazobactam versus meropenem for the definitive treatment of bsis caused by ceftriaxone not susceptible e coli or k pneumoniae that remained susceptible to piperacillintazobactam by current breakpoints. Whole genome analysis of cephalosporin resistant escherichia coli from bloodstream infections in australia new zealand and singapore. Harris pna ben zakour nl roberts lw et al.
A simplified illustration of ampc b lactamase expression. Among 379 patients mean age 665 years. Coli or klebsiella pneumoniae.
A basal ampc b lactamase productionb increased transcription of ampc in the presence of an inducing b lactam antibiotic that increases cell wall degradation production to levels beyond the capacity of ampd cleavage. Save this study trial of meropenem versus piperacillin tazobactam on mortality and clinial response merino ii the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. The merino trial is a landmark study published in september of 2018 that investigated piperacillin tazobactam versus meropenem for the treatment of bloodstream infection caused by ceftriaxone resistant e.
Cell wall degradation products accumulate and compete with udp n acetylmuramic acid peptides for binding to ampr.
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