Duration of antimicrobial treatment for uncomplicated streptococcal bacteraemia: Another example of shorter is better - 06/12/24
Summary |
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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | 336 episodes of uncomplicated streptococcal bacteraemia were included. |
• | 184 and 152 episodes received a short (5-10 days) and long (11-18 days) course. |
• | Primary endpoint: 120 days mortality, or bacteraemia recurrence. |
• | It was met by 43 (13%) episodes; 10% in short vs 16% in long course (P 0.143). |
• | Charlson comorbidity index >4 and septic shock were associated with primary endpoint. |
Keywords : Streptococci, Uncomplicated bacteraemia, Sepsis, Shorter is better, Duration of antimicrobial treatment
Plan
Vol 89 - N° 6
Article 106313- décembre 2024 Retour au numéro
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