Clinical characteristics and efficacy of short-course antibiotic therapy for bacteremia in hematological patients.

UNLABELLED

To explore the clinical characteristics and outcomes of bacteremia (SAB) in patients with hematological diseases and evaluate the efficacy of short-course antibiotic therapy for uncomplicated SAB in this group. We performed a retrospective study on hematological adult patients with SAB, including a high proportion of neutropenic patients. Logistic regression models fitted with inverse probability of treatment weighting were employed to evaluate the association between treatment duration and clinical outcomes in patients with uncomplicated SAB. A total of 242 patients infected with SAB were included, of whom 38 (15.7%) were caused by MRSA. The 90-day mortality and 30-day mortality rate were 11.2% ( = 27) and 4.5% ( = 11), respectively, while the 90-day recurrence rate was 5.4% ( = 13). Multivariate analysis indicated that advanced age (odds ratio [OR] = 1.063, = 0.004), relapsed or refractory hematological diseases (OR = 14.439, < 0.001), and polymicrobial infection (OR = 5.102, = 0.020) were independent predictors of 90-day mortality, while MRSA bacteremia was an independent predictor of 30-day mortality (OR = 14.091, = 0.009). Among 191 patients with uncomplicated SAB, 89 patients received short-course (median, 8.0 days; IQR, 7.0-9.0) and 102 received long-course therapy (median, 15.0 days; IQR, 12.0-19.3). In the weighted cohort, the multivariate analysis indicated that a short course of antibiotic treatment showed no significant relation with 90-day mortality (OR = 0.595, = 0.486), 30-day mortality (OR = 0.784, = 0.832) or 90-day recurrence (OR = 1.80, = 0.373). For hematological adult patients infected with SAB, MRSA, and polymicrobial infection associated with poor outcomes. Short-course antibiotic therapy for uncomplicated SAB seemed to yield similar clinical outcomes as long-course one.

IMPORTANCE

There is still no consensus on the optimal antibiotic course for bacteremia (SAB) in patients with hematological diseases. Some studies have suggested that short-course antibiotic therapy was feasible for uncomplicated SAB, but few have targeted hematological patients. Here, we described clinical characteristics and outcomes of SAB in hematological patients and highlighted advanced age, refractory or relapsed hematological diseases, and polymicrobial infection as independent predictors of 90-day mortality, while MRSA bacteremia was associated with early mortality risk. And we demonstrated that short-course antibiotic therapy (≤10 days) for uncomplicated SAB in hematological patients was non-inferior to long-course one (>10 days).