Matthew Crotty, Hadley Devall, Natalie Cook, Francis Fischer, Julie Alexander, Leigh Hunter, Edward Dominguez
{"title":"肺炎链球菌菌血症中抗生素使用时间长短的比较","authors":"Matthew Crotty, Hadley Devall, Natalie Cook, Francis Fischer, Julie Alexander, Leigh Hunter, Edward Dominguez","doi":"10.1093/ofid/ofae478","DOIUrl":null,"url":null,"abstract":"Background Streptococcus pneumoniae is a common pathogen associated with bloodstream infections (BSI), respiratory infections, peritonitis, infective endocarditis, and meningitis. Literature assessing duration of antibiotic therapy for a S. pneumoniae 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 S. pneumoniae bacteremia. Methods This retrospective, single-center cohort study assessed hospitalized patients with S. pneumoniae 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 BSI, and invasive infection. Rates of clinical failure (composite of 30-day hospital readmission, bacteremia recurrence, and mortality) were compared between the groups. Results 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 two 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 (LOS), median ICU LOS, or rate of Clostridioides difficile infection. Conclusion Shorter antibiotic courses may be appropriate in patients with S. pneumoniae bacteremia secondary to community-acquired pneumonia.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Short Versus Long Antibiotic Duration in Streptococcus pneumoniae Bacteremia\",\"authors\":\"Matthew Crotty, Hadley Devall, Natalie Cook, Francis Fischer, Julie Alexander, Leigh Hunter, Edward Dominguez\",\"doi\":\"10.1093/ofid/ofae478\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background Streptococcus pneumoniae is a common pathogen associated with bloodstream infections (BSI), respiratory infections, peritonitis, infective endocarditis, and meningitis. Literature assessing duration of antibiotic therapy for a S. pneumoniae 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 S. pneumoniae bacteremia. Methods This retrospective, single-center cohort study assessed hospitalized patients with S. pneumoniae 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 BSI, and invasive infection. Rates of clinical failure (composite of 30-day hospital readmission, bacteremia recurrence, and mortality) were compared between the groups. Results 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 two 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 (LOS), median ICU LOS, or rate of Clostridioides difficile infection. Conclusion Shorter antibiotic courses may be appropriate in patients with S. pneumoniae bacteremia secondary to community-acquired pneumonia.\",\"PeriodicalId\":19517,\"journal\":{\"name\":\"Open Forum Infectious Diseases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Forum Infectious Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ofid/ofae478\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae478","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Short Versus Long Antibiotic Duration in Streptococcus pneumoniae Bacteremia
Background Streptococcus pneumoniae is a common pathogen associated with bloodstream infections (BSI), respiratory infections, peritonitis, infective endocarditis, and meningitis. Literature assessing duration of antibiotic therapy for a S. pneumoniae 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 S. pneumoniae bacteremia. Methods This retrospective, single-center cohort study assessed hospitalized patients with S. pneumoniae 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 BSI, and invasive infection. Rates of clinical failure (composite of 30-day hospital readmission, bacteremia recurrence, and mortality) were compared between the groups. Results 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 two 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 (LOS), median ICU LOS, or rate of Clostridioides difficile infection. Conclusion Shorter antibiotic courses may be appropriate in patients with S. pneumoniae bacteremia secondary to community-acquired pneumonia.
期刊介绍:
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.