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Antimicrobial Therapy Duration for Bloodstream Infections Caused by Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex: A Retrospective Cohort Study

Background: Ideal therapy duration for Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex (ABC) bloodstream infections (BSI) is not defined, especially in the context of carbapenem resistance. In this study, we compared short- (≤7 days) and long-term (>7 days) antimicrobial t...

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Autores principales: Rodrigues, Rodrigo Douglas, Garcia, Rebeca Carvalho Lacerda, Bittencourt, Gabriel Almeida, Waichel, Vicente Bouchet, Garcia, Ester Carvalho Lacerda, Rigatto, Maria Helena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10044637/
https://www.ncbi.nlm.nih.gov/pubmed/36978405
http://dx.doi.org/10.3390/antibiotics12030538
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author Rodrigues, Rodrigo Douglas
Garcia, Rebeca Carvalho Lacerda
Bittencourt, Gabriel Almeida
Waichel, Vicente Bouchet
Garcia, Ester Carvalho Lacerda
Rigatto, Maria Helena
author_facet Rodrigues, Rodrigo Douglas
Garcia, Rebeca Carvalho Lacerda
Bittencourt, Gabriel Almeida
Waichel, Vicente Bouchet
Garcia, Ester Carvalho Lacerda
Rigatto, Maria Helena
author_sort Rodrigues, Rodrigo Douglas
collection PubMed
description Background: Ideal therapy duration for Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex (ABC) bloodstream infections (BSI) is not defined, especially in the context of carbapenem resistance. In this study, we compared short- (≤7 days) and long-term (>7 days) antimicrobial therapy duration for these infections. Methods: We performed a retrospective cohort study in two tertiary-care hospitals in Porto Alegre, Brazil, from 2013 to 2019. Eligible patients aged ≥18 years were included and excluded for the following criteria: polymicrobial infections, treatment with non-susceptible antibiotics, complicated infections, or early mortality (<8 days of active antimicrobial therapy). The 30-day mortality risk was evaluated using a Cox regression model. Results: We included 237 BSI episodes, 51.5% caused by ABC and 48.5% by Pseudomonas aeruginosa. Short-term therapy was not associated with 30-day mortality, adjusted hazard ratio 1.01, 95% confidence interval 0.47–2.20, p = 0.98, when adjusted for Pitt score (p = 0.02), Charlson Comorbidity Index score (p < 0.01), and carbapenem resistance (p < 0.01). Among patients who survived, short-term therapy was associated with shorter hospital stay (p < 0.01). Results were maintained in the subgroups of BSI caused by carbapenem-resistant bacteria (p = 0.76), ABC (p = 0.61), and Pseudomonas aeruginosa (p = 0.39). Conclusions: Long-term therapies for non-complicated Pseudomonas aeruginosa and ABC BSI were not superior to short-term therapy for 30-day mortality.
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spelling pubmed-100446372023-03-29 Antimicrobial Therapy Duration for Bloodstream Infections Caused by Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex: A Retrospective Cohort Study Rodrigues, Rodrigo Douglas Garcia, Rebeca Carvalho Lacerda Bittencourt, Gabriel Almeida Waichel, Vicente Bouchet Garcia, Ester Carvalho Lacerda Rigatto, Maria Helena Antibiotics (Basel) Brief Report Background: Ideal therapy duration for Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex (ABC) bloodstream infections (BSI) is not defined, especially in the context of carbapenem resistance. In this study, we compared short- (≤7 days) and long-term (>7 days) antimicrobial therapy duration for these infections. Methods: We performed a retrospective cohort study in two tertiary-care hospitals in Porto Alegre, Brazil, from 2013 to 2019. Eligible patients aged ≥18 years were included and excluded for the following criteria: polymicrobial infections, treatment with non-susceptible antibiotics, complicated infections, or early mortality (<8 days of active antimicrobial therapy). The 30-day mortality risk was evaluated using a Cox regression model. Results: We included 237 BSI episodes, 51.5% caused by ABC and 48.5% by Pseudomonas aeruginosa. Short-term therapy was not associated with 30-day mortality, adjusted hazard ratio 1.01, 95% confidence interval 0.47–2.20, p = 0.98, when adjusted for Pitt score (p = 0.02), Charlson Comorbidity Index score (p < 0.01), and carbapenem resistance (p < 0.01). Among patients who survived, short-term therapy was associated with shorter hospital stay (p < 0.01). Results were maintained in the subgroups of BSI caused by carbapenem-resistant bacteria (p = 0.76), ABC (p = 0.61), and Pseudomonas aeruginosa (p = 0.39). Conclusions: Long-term therapies for non-complicated Pseudomonas aeruginosa and ABC BSI were not superior to short-term therapy for 30-day mortality. MDPI 2023-03-08 /pmc/articles/PMC10044637/ /pubmed/36978405 http://dx.doi.org/10.3390/antibiotics12030538 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Rodrigues, Rodrigo Douglas
Garcia, Rebeca Carvalho Lacerda
Bittencourt, Gabriel Almeida
Waichel, Vicente Bouchet
Garcia, Ester Carvalho Lacerda
Rigatto, Maria Helena
Antimicrobial Therapy Duration for Bloodstream Infections Caused by Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex: A Retrospective Cohort Study
title Antimicrobial Therapy Duration for Bloodstream Infections Caused by Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex: A Retrospective Cohort Study
title_full Antimicrobial Therapy Duration for Bloodstream Infections Caused by Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex: A Retrospective Cohort Study
title_fullStr Antimicrobial Therapy Duration for Bloodstream Infections Caused by Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex: A Retrospective Cohort Study
title_full_unstemmed Antimicrobial Therapy Duration for Bloodstream Infections Caused by Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex: A Retrospective Cohort Study
title_short Antimicrobial Therapy Duration for Bloodstream Infections Caused by Pseudomonas aeruginosa or Acinetobacter baumannii-calcoaceticus complex: A Retrospective Cohort Study
title_sort antimicrobial therapy duration for bloodstream infections caused by pseudomonas aeruginosa or acinetobacter baumannii-calcoaceticus complex: a retrospective cohort study
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10044637/
https://www.ncbi.nlm.nih.gov/pubmed/36978405
http://dx.doi.org/10.3390/antibiotics12030538
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