Short versus long duration antimicrobial treatment for community-onset bacteraemia: A propensity score matching study

doi:10.1016/j.ijantimicag.2019.05.014

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Title:	Short versus long duration antimicrobial treatment for community-onset bacteraemia: A propensity score matching study
Authors:	Lee, Ching-Chi Hsieh, Chih-Chia Yang, Chao-Yung Hong, Ming-Yuan Lee, Chung-Hsun Hung-Jen Tang(湯宏仁) Ko, Wen-Chien
Contributors:	Sin Lau Hosp, Dept Adult Crit Care Med Chang Jung Christian Univ, Coll Hlth Sci, Grad Inst Med Sci Natl Cheng Kung Univ Hosp, Dept Internal Med Natl Cheng Kung Univ Hosp, Dept Emergency Med Natl Cheng Kung Univ, Coll Med, Dept Med Chi Mei Med Ctr, Dept Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Natl Cheng Kung Univ Hosp, Dept Internal Med, Div Infect Dis
Keywords:	Short-course Antimicrobial therapy Antimicrobial-resistant Community-onset Bloodstream infection Bacteraemia
Date:	2019-08
Issue Date:	2020-07-29 13:53:36 (UTC+8)
Publisher:	ELSEVIER
Abstract:	The efficacy and safety of short-course intravenous (i.v.) antimicrobial therapy for bloodstream infections is unknown. Therefore, a retrospective 8-year cohort study including 1431 hospitalised adults was conducted to compare the outcomes of patients receiving short-course (5-10 days) and long-course (11-16 days) i.v. antibiotic therapy for community-onset bacteraemia. Of 1010 patients who received short-course therapy, 726 were matched with 363 patients in the long-course group through propensity score matching at a ratio of 1:2 based on independent predictors of 30-day mortality identified in the multivariate regression model. Following appropriate matching, similarities between the two groups in the proportion of baseline characteristics (age, sex, major co-morbidities, co-morbidity severity, bacteraemia severity at onset and major bacteraemia sources) and 30-day crude mortality rate after bacteraemia onset were observed. Notably, clinical outcomes within 30 days after the end of i.v. therapy, in terms of proportions of post-treatment overall infections (2.2% vs. 6.1%; P = 0.001), infections caused by antimicrobial-resistant pathogens (ARPs) (1.7% vs. 4.4%; P = 0.007), and thereby post-treatment crude mortality (1.4% vs. 3.6%; P = 0.009), were lower in the short-course group. In conclusion, for adults with community-onset uncomplicated bacteraemia, short-course (5-10 days) i.v. antibiotic treatment did not result in an increased risk of mortality but instead decreased the odds of overall and ARP infections after the treatment course. (C) 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.
Relation:	International Journal of Antimicrobial Agents, v.54, n.2, pp.176-183
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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