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Coli or klebsiella pneumoniae. Pneumoniae were after 3 days of empiric therapy randomized to intravenous pip tazo or meropenem. This has been an ongoing point of debate in the world of gram negative bacilli.
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Wiki journal club wjc summarizes and reviews landmark studies across medicine and surgical specialties. 11 this study was an international multicenter open label randomized noninferiority trial of ptz 45 g every 6 hours versus meropenem 1 g every 8 hours for the definitive treatment of e coli or k pneumoniae bloodstream infections resistant to ceftriaxone. No drug at all.

In the pip tazo group 23 of 187 patients 123 died within 30 days compared to 7 of 191 37 in the meropenem group risk difference 86 1. 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. The merino trial offered to overcome some of the discrepancies seen in the previous studies.

In short in the merino trial patients with bsi caused by ceftriaxone nonsusceptible e. The merino trial and implications for esbl bacteremia treatment. Official journal of the association of medical microbiology and infectious disease canada.

Bright young doctors sit in a hospital workroom putting the finishing touches on what are undoubtedly the most comprehensive and yes simply the best consult notes in their respective patients. The merino trial provides the best evidence yet that carbapenems are preferable to piperacillin tazobactam for the treatment of serious infections due to esbl producing organisms.

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