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The following is a summary of “Role of early use of Carbapenems perioperatively for urolithiasis with ESBL-producing Escherichia coli,” published in the September 2024 issue of Urology by Li et al. 

Urolithiasis, or kidney stones, with extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli poses treatment challenges and increases postoperative infection complications. 

Researchers conducted a prospective study to evaluate early carbapenem use in patients with urolithiasis with infections caused by ESBL-producing Escherichia coli. 

They included 626 patients, dividing them into 2 groups: Group I (the ESBL-producing E. coli group) and Group II (the non-ESBL-producing E. coli group). Antibiotic susceptibility testing was conducted, and postoperative infection-related events were recorded for both groups to evaluate the efficacy of perioperative antibiotics. 

The results showed that all E. coli strains in the study were sensitive to carbapenem antibiotics. The resistance rates of ESBL-producing E. coli to 6 commonly used antibiotics were higher than those of non-ESBL-producing strains. Based on the preoperative antibiotic susceptibility test for the ESBL-producing E. coli group and the quick Sequential Organ Failure Assessment (qSOFA) score, carbapenems were more effective than β-lactamase inhibitors (P=0.08). For the non-ESBL-producing E. coli group, there was no difference in treatment effects between carbapenems, β-lactamase inhibitors, ceftazidime, and quinolones (P=0.975). 

The study concluded that carbapenem antibiotics significantly reduced postoperative infection-related events compared to other antibiotics for ESBL-producing E. coli infections in patients with urolithiasis. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01572-y#Abs1