1University of Toledo Medical Center, Toledo, Ohio.
2College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, Ohio.
Surg Infect (Larchmt). 2019 Sep;20(6):519-523. doi: 10.1089/sur.2019.011. Epub 2019 May 20.
Guidelines recommend an antimicrobial therapy duration of four to seven days for intra-abdominal infections (IAIs). Despite evidence that shorter treatments are appropriate for this disease state, longer durations frequently are utilized in clinical practice. This study compared the clinical outcomes of short course (SC) and prolonged course (PC) antimicrobial therapy for IAI. This was a noninterventional, retrospective, single-center study. Adults admitted with documented IAI who received antimicrobial treatment for ≥48 hours were included. A total of 175 patients were enrolled, 73 patients receiving SC (≤7 days) and 102 patients receiving PC (>7 days) therapy. No significant differences were observed in the primary outcome of clinical cure (74% versus 67.6%; p = 0.367). Secondary outcomes including hospital length of stay (LOS) (5.5 versus 5.8 days; p = 0.372), intensive care unit (ICU) LOS (3 versus 5 days; p = 0.117), 28-day all-cause mortality rate (4.1% versus 2%; p = 0.651), and 30-day re-admission rate (19.2% versus 20.6%; p = 0.818) also were not significantly different. There was no significant difference in the rate of clinical cure between SC and PC antimicrobial therapy. These results further support guideline recommendations for a shorter duration of antimicrobial therapy in IAI.
指南建议腹腔内感染 (IAI) 的抗菌治疗疗程为 4 至 7 天。尽管有证据表明较短的治疗方案适用于这种疾病状态，但在临床实践中经常使用更长的疗程。本研究比较了腹腔内感染短期（SC）和长期（PC）抗菌治疗的临床结果。这是一项非干预性、回顾性、单中心研究。纳入了接受抗菌治疗≥48 小时并有记录的腹腔内感染的成年患者。共纳入 175 例患者，73 例接受 SC（≤7 天）治疗，102 例接受 PC（>7 天）治疗。临床治愈率（74%与 67.6%；p=0.367）的主要结局无显著差异。次要结局包括住院时间（LOS）（5.5 天与 5.8 天；p=0.372）、重症监护病房（ICU）LOS（3 天与 5 天；p=0.117）、28 天全因死亡率（4.1%与 2%；p=0.651）和 30 天再入院率（19.2%与 20.6%；p=0.818）也无显著差异。SC 和 PC 抗菌治疗的临床治愈率无显著差异。这些结果进一步支持指南关于腹腔内感染抗菌治疗疗程更短的建议。
