Temocillin vs Meropenem for the Targeted Treatment of Bacteraemia Resistant to Third Gen Cephalosporins

Inclusion Criteria:

• Adult patients with monomicrobial bacteremia due to Enterobacteriaceae showingresistance to cefotaxime, ceftriaxone (MIC >2 mg/L) and/or ceftazidime (MIC >4mg/L), and sensible to temocillin (MIC ≤8 mg/L, except in bacteremia only of urinaryorigin, for which the criterion is MIC ≤16 mg/L ) and meropenem (MIC ≤2 mg/L).

• Duration of intravenous treatment is planned to be at least 4 days.

• The patient signed informed consent form.

Exclusion Criteria:

• <18 years

• Pregnancy

• Breastfeeding

• Palliative care

• Allergy to betalactams

• Polymicrobial bacteraemia

• Infections typically needing prolonged >14 days of therapy (e.g., endocarditis,prosthetic joint infection, vascular graft infection, empyema, chronic prostatitis)or meningitis

• Active empirical treatment> 96 hours after initial blood culture extraction

• Delay in inclusion> 48 h

• Recruited in another clinical trial with active treatment

• Peritoneal dialysis or continuous hemofiltration

• extreme gravity or imminent death