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Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible

Data about short courses of antibiotic therapy for Gram-negative bacilli (GNB) bacteremia in immunosuppressed patients are limited. This is a prospective observational study performed on adult patients with cancer and hematopoietic stem cell transplant (HSCT) who developed GNB bacteremia and receive...

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Autores principales: Herrera, Fabián, Torres, Diego, Carena, Alberto, Nicola, Federico, Rearte, Andrés, Temporiti, Elena, Jorge, Laura, Valentini, Ricardo, Bues, Florencia, Relloso, Silvia, Bonvehí, Pablo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963170/
https://www.ncbi.nlm.nih.gov/pubmed/36838476
http://dx.doi.org/10.3390/microorganisms11020511
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author Herrera, Fabián
Torres, Diego
Carena, Alberto
Nicola, Federico
Rearte, Andrés
Temporiti, Elena
Jorge, Laura
Valentini, Ricardo
Bues, Florencia
Relloso, Silvia
Bonvehí, Pablo
author_facet Herrera, Fabián
Torres, Diego
Carena, Alberto
Nicola, Federico
Rearte, Andrés
Temporiti, Elena
Jorge, Laura
Valentini, Ricardo
Bues, Florencia
Relloso, Silvia
Bonvehí, Pablo
author_sort Herrera, Fabián
collection PubMed
description Data about short courses of antibiotic therapy for Gram-negative bacilli (GNB) bacteremia in immunosuppressed patients are limited. This is a prospective observational study performed on adult patients with cancer and hematopoietic stem cell transplant (HSCT) who developed GNB bacteremia and received appropriate empirical antibiotic therapy (EAT), had a clinical response within 7 days and survived 48 h after the end of therapy. They received antibiotic therapy in the range of 7–15 days and were divided into short course, with a median of 7 days (SC), or long course, with a median of 14 days (LC). Seventy-four patients were included (SC: 36 and LC: 38). No differences were observed in baseline characteristics or in the presence of neutropenia: 58.3% vs. 60.5% (p = 0.84). Clinical presentation and microbiological characteristics were similar in SC and LC, respectively: clinical source of bacteremia 72.2% vs. 76.3% (p = 0.68); shock 2.8% vs. 10.5% (p = 0.35) and multidrug-resistant GNB 27.8% vs. 21.1% (p = 0.50). Overall, mortality was 2.8% vs. 7.9% (p = 0.61), and bacteremia relapse was 2.8% vs. 0 (p = 0.30). The length of hospitalization since bacteremia was 7 days (interquartile range (IQR), 6–15) for SC and 12 days (IQR, 7–19) (p = 0.021) for LC. In the case of patients with cancer or HSCT and GNB bacteremia who receive appropriate EAT with clinical response, 7 days of antibiotic therapy might be adequate.
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spelling pubmed-99631702023-02-26 Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible Herrera, Fabián Torres, Diego Carena, Alberto Nicola, Federico Rearte, Andrés Temporiti, Elena Jorge, Laura Valentini, Ricardo Bues, Florencia Relloso, Silvia Bonvehí, Pablo Microorganisms Article Data about short courses of antibiotic therapy for Gram-negative bacilli (GNB) bacteremia in immunosuppressed patients are limited. This is a prospective observational study performed on adult patients with cancer and hematopoietic stem cell transplant (HSCT) who developed GNB bacteremia and received appropriate empirical antibiotic therapy (EAT), had a clinical response within 7 days and survived 48 h after the end of therapy. They received antibiotic therapy in the range of 7–15 days and were divided into short course, with a median of 7 days (SC), or long course, with a median of 14 days (LC). Seventy-four patients were included (SC: 36 and LC: 38). No differences were observed in baseline characteristics or in the presence of neutropenia: 58.3% vs. 60.5% (p = 0.84). Clinical presentation and microbiological characteristics were similar in SC and LC, respectively: clinical source of bacteremia 72.2% vs. 76.3% (p = 0.68); shock 2.8% vs. 10.5% (p = 0.35) and multidrug-resistant GNB 27.8% vs. 21.1% (p = 0.50). Overall, mortality was 2.8% vs. 7.9% (p = 0.61), and bacteremia relapse was 2.8% vs. 0 (p = 0.30). The length of hospitalization since bacteremia was 7 days (interquartile range (IQR), 6–15) for SC and 12 days (IQR, 7–19) (p = 0.021) for LC. In the case of patients with cancer or HSCT and GNB bacteremia who receive appropriate EAT with clinical response, 7 days of antibiotic therapy might be adequate. MDPI 2023-02-17 /pmc/articles/PMC9963170/ /pubmed/36838476 http://dx.doi.org/10.3390/microorganisms11020511 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 Article
Herrera, Fabián
Torres, Diego
Carena, Alberto
Nicola, Federico
Rearte, Andrés
Temporiti, Elena
Jorge, Laura
Valentini, Ricardo
Bues, Florencia
Relloso, Silvia
Bonvehí, Pablo
Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible
title Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible
title_full Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible
title_fullStr Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible
title_full_unstemmed Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible
title_short Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible
title_sort short course of antibiotic therapy for gram-negative bacilli bacteremia in patients with cancer and hematopoietic stem cell transplantation: less is possible
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963170/
https://www.ncbi.nlm.nih.gov/pubmed/36838476
http://dx.doi.org/10.3390/microorganisms11020511
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