This study was conducted to assess the clinical outcomes of bloodstream infections caused by extended-spectrum P-lactamase-producing Escherichia coli. A total of 53 patients were included in the study. Forty-five patients (84.9%) received appropriate antibiotic therapy. Initial empirical treatment was appropriate in 12 patients, whereas the antibiotic was changed according to susceptibility results in the remaining 33 patients. Carbapenems were active against all strains and were the choice of therapy for 71.6% of patients. The 30-day mortality rate was 26.4%. The presence of diabetes mellitus and Intensive Care Unit stay at the time of bacteraemia were significantly associated with a poor outcome. The 'appropriateness' of the antibiotic regimen had no significant influence on survival. (c) 2005 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.