Nicolas Fourré , Virgile Zimmermann , Laurence Senn , Marion Aruanno , Benoit Guery , Matthaios Papadimitriou-Olivgeris
{"title":"无并发症链球菌菌血症的抗菌治疗时间:时间越短越好的另一个例子","authors":"Nicolas Fourré , Virgile Zimmermann , Laurence Senn , Marion Aruanno , Benoit Guery , Matthaios Papadimitriou-Olivgeris","doi":"10.1016/j.jinf.2024.106313","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Duration of treatment for uncomplicated streptococcal bacteraemia is unknown. The study aims to assess clinical outcomes of patients with uncomplicated streptococcal bacteraemia receiving a short course (5–10 days) of antimicrobial treatment compared to those receiving the traditional, longer duration (11–18 days).</div></div><div><h3>Methods</h3><div>This retrospective study was conducted at the Lausanne University Hospital, Switzerland and included episodes of uncomplicated streptococcal bacteraemia among adult patients from 2015 to 2023. Clinical failure was defined as mortality, recurrence of bacteraemia by the same streptococcal species and development in bone and joint infection within 120 days.</div></div><div><h3>Results</h3><div>During the study period, 336 episodes of uncomplicated streptococcal bacteraemia were included. The median duration of antimicrobial treatment was 10 days (interquartile range: 7–14); 184 (55%) and 152 (45%) episodes received a short (5–10 days) and long (11–18 days) duration of antimicrobial treatment, respectively. Forty-three (13%) episodes had clinical failure; 120-day mortality was 11% (36 episodes); recurrence of bacteraemia by the same streptococcal species was observed in 8 episodes (2%). No difference in clinical failure was observed between episodes receiving short and long courses of antimicrobial treatment (10% versus 16%; <em>P</em> 0.143). The Cox multivariable regression model found that a Charlson comorbidity index >4 (aHR 4.87, 95% CI 3.08–7.71), and septic shock (1.67, 1.04–2.67) were associated with clinical failure; a short course of antimicrobial treatment was not associated with clinical failure (0.90, 0.57–1.12).</div></div><div><h3>Conclusions</h3><div>This study has shown that a short duration of antimicrobial treatment for cases of streptococcal bacteraemia is effective and safe.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"89 6","pages":"Article 106313"},"PeriodicalIF":14.3000,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Duration of antimicrobial treatment for uncomplicated streptococcal bacteraemia: Another example of shorter is better\",\"authors\":\"Nicolas Fourré , Virgile Zimmermann , Laurence Senn , Marion Aruanno , Benoit Guery , Matthaios Papadimitriou-Olivgeris\",\"doi\":\"10.1016/j.jinf.2024.106313\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>Duration of treatment for uncomplicated streptococcal bacteraemia is unknown. The study aims to assess clinical outcomes of patients with uncomplicated streptococcal bacteraemia receiving a short course (5–10 days) of antimicrobial treatment compared to those receiving the traditional, longer duration (11–18 days).</div></div><div><h3>Methods</h3><div>This retrospective study was conducted at the Lausanne University Hospital, Switzerland and included episodes of uncomplicated streptococcal bacteraemia among adult patients from 2015 to 2023. Clinical failure was defined as mortality, recurrence of bacteraemia by the same streptococcal species and development in bone and joint infection within 120 days.</div></div><div><h3>Results</h3><div>During the study period, 336 episodes of uncomplicated streptococcal bacteraemia were included. The median duration of antimicrobial treatment was 10 days (interquartile range: 7–14); 184 (55%) and 152 (45%) episodes received a short (5–10 days) and long (11–18 days) duration of antimicrobial treatment, respectively. Forty-three (13%) episodes had clinical failure; 120-day mortality was 11% (36 episodes); recurrence of bacteraemia by the same streptococcal species was observed in 8 episodes (2%). No difference in clinical failure was observed between episodes receiving short and long courses of antimicrobial treatment (10% versus 16%; <em>P</em> 0.143). The Cox multivariable regression model found that a Charlson comorbidity index >4 (aHR 4.87, 95% CI 3.08–7.71), and septic shock (1.67, 1.04–2.67) were associated with clinical failure; a short course of antimicrobial treatment was not associated with clinical failure (0.90, 0.57–1.12).</div></div><div><h3>Conclusions</h3><div>This study has shown that a short duration of antimicrobial treatment for cases of streptococcal bacteraemia is effective and safe.</div></div>\",\"PeriodicalId\":50180,\"journal\":{\"name\":\"Journal of Infection\",\"volume\":\"89 6\",\"pages\":\"Article 106313\"},\"PeriodicalIF\":14.3000,\"publicationDate\":\"2024-10-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0163445324002470\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0163445324002470","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Duration of antimicrobial treatment for uncomplicated streptococcal bacteraemia: Another example of shorter is better
Objectives
Duration of treatment for uncomplicated streptococcal bacteraemia is unknown. The study aims to assess clinical outcomes of patients with uncomplicated streptococcal bacteraemia receiving a short course (5–10 days) of antimicrobial treatment compared to those receiving the traditional, longer duration (11–18 days).
Methods
This retrospective study was conducted at the Lausanne University Hospital, Switzerland and included episodes of uncomplicated streptococcal bacteraemia among adult patients from 2015 to 2023. Clinical failure was defined as mortality, recurrence of bacteraemia by the same streptococcal species and development in bone and joint infection within 120 days.
Results
During the study period, 336 episodes of uncomplicated streptococcal bacteraemia were included. The median duration of antimicrobial treatment was 10 days (interquartile range: 7–14); 184 (55%) and 152 (45%) episodes received a short (5–10 days) and long (11–18 days) duration of antimicrobial treatment, respectively. Forty-three (13%) episodes had clinical failure; 120-day mortality was 11% (36 episodes); recurrence of bacteraemia by the same streptococcal species was observed in 8 episodes (2%). No difference in clinical failure was observed between episodes receiving short and long courses of antimicrobial treatment (10% versus 16%; P 0.143). The Cox multivariable regression model found that a Charlson comorbidity index >4 (aHR 4.87, 95% CI 3.08–7.71), and septic shock (1.67, 1.04–2.67) were associated with clinical failure; a short course of antimicrobial treatment was not associated with clinical failure (0.90, 0.57–1.12).
Conclusions
This study has shown that a short duration of antimicrobial treatment for cases of streptococcal bacteraemia is effective and safe.
期刊介绍:
The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection.
Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.