MERINO Trial: Piperacillin-Tazobactam vs Meropenem in ESBL infections

MERINO Trial of using pip tazo for patients with ESBL infection

MERINO Trial: 2018, Pip-Tazo vs Meropenem in patients with E-coli or Klebsiella infections,  JAMA

Earlier cohort studies yielded conflicting results when it comes to treating ceftriaxone-resistant E-coli and Klebsiella infections. Some studies reported noninferiority of piperacillin-tazobactam when compared to meropenem while others reported almost doubling of mortality.

In the MERINO trial, the patients were randomized to assess for non-inferiority of pip-tazo IV therapy versus IV meropenem. The results showed 12.3% 30-day mortality in the pip-tazo group compared to 3.7% with meropenem. Therefore, the study concluded that for E-coli and Klebsiella bloodstream infections, pip-tazo antibiotic is inferior to meropenem in terms of 30 days mortality.