In this collaborative episode of Breakpoints and Communicable, the hosts revisit the “trial run” session from ESCMID Global, a format designed to facilitate critical discussion of major infectious diseases trials. This episode focuses on two studies addressing bloodstream infections caused by third‑generation cephalosporin-resistant Enterobacterales [1].

Mical Paul (Rambam Health Care Campus, Israel) joins the podcast to discuss the PETER PEN trial [1,2], comparing piperacillin/tazobactam with meropenem, including its design, interim analyses, and interpretation alongside prior data such as MERINO. The episode also features Jesús Rodríguez‑Baño (University of Seville, Spain), who presents a post hoc analysis of the ASTARTE trial [1,3], comparing temocillin and carbapenems.

This episode was edited by Lacy Worden and was peer reviewed by Jeanette Bouchard (Duke Antimicrobial Stewardship Outreach Network (DASON) Durham, NC, USA).

References

1. Paul, M., & Rodríguez-Baño, J. (2026, April 20). The trial run: treatment of ESBL bacteraemia - off to never-never land. [Presentation]. ESCMID Global 2026, Munich, Germany. ESCMID Global Virtual Platform.
2. Bitterman R, Koppel F, Mussini C, et al. Piperacillin-tazobactam versus meropenem for treatment of bloodstream infections caused by third-generation cephalosporin-resistant Enterobacteriaceae: a study protocol for a non-inferiority open-label randomised controlled trial (PeterPen). BMJ Open. 2021;11(2):e040210. Published 2021 Feb 8. doi: 10.1136/bmjopen-2020-040210 
3. Marín-Candón A, Rosso-Fernández CM, Bustos de Godoy N, et al. Temocillin versus meropenem for the targeted treatment of bacteraemia due to third-generation cephalosporin-resistant Enterobacterales (ASTARTÉ): protocol for a randomised, pragmatic trial [Internet]. BMJ Open. 2021 Sep 27;11(9):e049481. doi: 10.1136/bmjopen-2021-049481 

Further reading

• Harris PNA, et al. Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance: A Randomized Clinical Trial. JAMA. 2018;320(10):984–994. doi: 10.1001/jama.2018.12163.