Faculty of Medicine, University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Australia; Infection Management Services, Princess Alexandra Hospital, Brisbane, Australia.
Faculty of Medicine, University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Australia.
Int J Antimicrob Agents. 2023 Jun;61(6):106802. doi: 10.1016/j.ijantimicag.2023.106802. Epub 2023 Apr 2.
To understand current practice in terms of duration of antibiotic treatment and timing of intravenous (IV) to oral switching for common bacteraemic conditions amongst infectious diseases (ID) and intensive care unit (ICU) physicians.
An online survey consisting of 18 questions comprising five common clinical bacteraemia scenarios [adapted from the original survey designed by the University of Toronto (Toronto, Ontario, Canada)] was conducted amongst Turkish ID and ICU physicians between November 2020 and November 2021.
In total, 236 physicians (76.5% ID and 17.5% ICU) responded. The most commonly recommended duration of antibiotic treatment for bacteraemia was 14 days (42%), followed by 10 (27%) and 7 (18%) days. The median recommended treatment durations were 10 [interquartile range (IQR) 10-14] days for central-venous-catheter-associated bloodstream infection, 10 (IQR 7-14) days for bacteraemic pneumonia, 14 (IQR 10-14) days for bacteraemic urinary tract and intra-abdominal infections, and 14 (IQR 7-14) days for bacteraemic skin and soft tissue infection. Carbapenem resistance influenced the recommendations, but pathogen type did not. No significant difference in responses for most scenarios was found between ID and ICU physicians. Switching to oral antibiotics after a median duration of 7 (IQR 5-7) days of IV treatment was considered by 80% of respondents.
Prolonged treatment was recommended for most clinical scenarios. Extended IV durations were recommended before oral switching. A presumption that resistant bacterial infections require longer therapy may be responsible for prolonged treatment durations.
了解传染病（ID）和重症监护病房（ICU）医生在常见菌血症情况下抗生素治疗持续时间和静脉（IV）到口服转换时机的当前实践。
我们于 2020 年 11 月至 2021 年 11 月期间，针对土耳其 ID 和 ICU 医生，开展了一项包含 18 个问题的在线调查，其中包含 5 种常见临床菌血症情况（改编自加拿大安大略省多伦多大学（多伦多）的原始调查）。
共有 236 名医生（76.5%为 ID，17.5%为 ICU）做出回应。菌血症抗生素治疗最常推荐的持续时间为 14 天（42%），其次为 10 天（27%）和 7 天（18%）。推荐的中位治疗持续时间分别为：中心静脉导管相关血流感染 10 天（四分位距 [IQR] 10-14 天），菌血症性肺炎 10 天（IQR 7-14 天），菌血症性尿路感染和腹腔内感染 14 天（IQR 10-14 天），菌血症性皮肤和软组织感染 14 天（IQR 7-14 天）。碳青霉烯耐药会影响推荐，但病原体类型没有影响。ID 和 ICU 医生对大多数情况下的反应没有显著差异。80%的受访者认为，在静脉治疗 7（IQR 5-7）天后，应转换为口服抗生素。
大多数临床情况下推荐延长治疗。在口服转换之前，建议延长 IV 治疗时间。可能认为耐药细菌感染需要更长的治疗时间，这导致了治疗时间的延长。
