Crotty Matthew, Devall Hadley, Cook Natalie, Fischer Francis, Alexander Julie, Hunter Leigh, Dominguez Edward
Department of Pharmacy, Methodist Dallas Medical Center, Dallas, Texas, USA.
Department of Internal Medicine, Methodist Dallas Medical Center, Dallas, Texas, USA.
Open Forum Infect Dis. 2024 Aug 30;11(9):ofae478. doi: 10.1093/ofid/ofae478. eCollection 2024 Sep.
is a common pathogen associated with bloodstream infections, respiratory infections, peritonitis, infective endocarditis, and meningitis. Literature assessing duration of antibiotic therapy for a bacteremia secondary to common infection is scarce, leading to variability in practice. Therefore, this study evaluated the effectiveness of short (5-10 days) versus long (11-16 days) antibiotic durations for bacteremia.
This retrospective, single-center cohort study assessed hospitalized patients with -positive blood cultures, who received active antibiotics within 48 hours of first positive blood culture collection and achieved clinical stability by day 10 of the first positive blood culture collection. Exclusion criteria included treatment duration <5 or >16 days, death before completion of 10 days of therapy, polymicrobial bloodstream infection, and invasive infection. Rates of clinical failure (composite of 30-day hospital readmission, bacteremia recurrence, and mortality) were compared between the groups.
A total of 162 patients were included, with 51 patients in the short- and 111 patients in the long-duration group. Pneumonia was the suspected source of bacteremia in 90.1% of patients. Rates of clinical failure were not significantly different between the 2 groups. Patients received a median antibiotic course of 7 days in the short group compared to 14 days in the long group; however, there was no significant difference observed in the median hospital length of stay, median intensive care unit length of stay, or rate of infection.
Shorter antibiotic courses may be appropriate in patients with bacteremia secondary to community-acquired pneumonia.
是一种与血流感染、呼吸道感染、腹膜炎、感染性心内膜炎和脑膜炎相关的常见病原体。评估常见感染继发菌血症的抗生素治疗持续时间的文献稀缺,导致实践中存在差异。因此,本研究评估了短疗程(5 - 10天)与长疗程(11 - 16天)抗生素治疗菌血症的有效性。
这项回顾性、单中心队列研究评估了血培养阳性的住院患者,这些患者在首次血培养阳性采集后48小时内接受了有效抗生素治疗,并在首次血培养阳性采集后第10天达到临床稳定。排除标准包括治疗持续时间<5天或>16天、治疗10天前死亡、多微生物血流感染和侵袭性感染。比较两组的临床失败率(30天再入院、菌血症复发和死亡率的综合指标)。
共纳入162例患者,短疗程组51例,长疗程组111例。90.1%的患者菌血症的疑似来源为肺炎。两组的临床失败率无显著差异。短疗程组患者的抗生素疗程中位数为7天,长疗程组为14天;然而,在中位住院时间、中位重症监护病房住院时间或感染率方面未观察到显著差异。
对于社区获得性肺炎继发菌血症的患者,较短的抗生素疗程可能是合适的。