Clinical Outcomes with Ertapenem for Pneumonia in Obese versus Nonobese Patients

Abstract

The objective of this study was to compare the rate of pneumonia resolution in obese (BMI ≥ 30 kg/m 2 ) and non-obese (BMI < 30 kg/m 2 ) patients treated with ertapenem one gram daily. This was a retrospective cohort study evaluating patients treated at The Ohio State University Wexner Medical Center between January 1, 2015 and August 31, 2020. Patients were included if they were between 18 and 89 years old and received ertapenem for at least 48 hours for pneumonia. Patients were excluded if pregnant, incarcerated, had renal impairment, received antibiotics with gram-negative activity for a significant period prior to or in addition to ertapenem, and patients with other concomitant deep-seated infections. The primary outcome of clinical resolution was defined as meeting any of three criteria in order of evaluation: discontinuation of antibiotics by day 8 of therapy, afebrile while on ertapenem in addition to a decrease in white blood cell count, or improvement on chest radiograph at day 7 of therapy. A multivariable logistic regression analysis was performed to examine the association between obesity and clinical resolution, while adjusting for proven confounders. There were 76 non-obese and 65 obese patients included. The median patient BMI was 23.7 kg/m 2 (21.0-26.9) and 35.0 kg/m 2 (32.8-39.8) for the non-obese and obese cohorts, respectively. Clinical resolution was achieved in 78% (59/76) of non-obese and 75% (49/65) of obese patients (p=0.75) without an observed difference in the regression model. Outcomes were similar in obese and non-obese patients treated with ertapenem one gram daily for pneumonia.