摘要
The efficacy and safety of short-course intravenous (i.v.) antimicrobial therapy for bloodstream infections is unknown. Therefore, a retrospective 8-year cohort study including 1431 hospitalised adults was conducted to compare the outcomes of patients receiving short-course (5–10 days) and long-course (11–16 days) i.v. antibiotic therapy for community-onset bacteraemia. Of 1010 patients who received short-course therapy, 726 were matched with 363 patients in the long-course group through propensity score matching at a ratio of 1:2 based on independent predictors of 30-day mortality identified in the multivariate regression model. Following appropriate matching, similarities between the two groups in the proportion of baseline characteristics (age, sex, major co-morbidities, co-morbidity severity, bacteraemia severity at onset and major bacteraemia sources) and 30-day crude mortality rate after bacteraemia onset were observed. Notably, clinical outcomes within 30 days after the end of i.v. therapy, in terms of proportions of post-treatment overall infections (2.2% vs. 6.1%; P = 0.001), infections caused by antimicrobial-resistant pathogens (ARPs) (1.7% vs. 4.4%; P = 0.007), and thereby post-treatment crude mortality (1.4% vs. 3.6%; P = 0.009), were lower in the short-course group. In conclusion, for adults with community-onset uncomplicated bacteraemia, short-course (5–10 days) i.v. antibiotic treatment did not result in an increased risk of mortality but instead decreased the odds of overall and ARP infections after the treatment course.
| 原文 | English |
|---|---|
| 頁（從 - 到） | 176-183 |
| 頁數 | 8 |
| 期刊 | International journal of antimicrobial agents |
| 卷 | 54 |
| 發行號 | 2 |
| DOIs | |
| 出版狀態 | Published - 2019 八月 |
指紋
All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases
- Pharmacology (medical)
引用此文
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Short versus long duration antimicrobial treatment for community-onset bacteraemia : A propensity score matching study. / Lee, Ching Chi; Hsieh, Chih Chia; Yang, Chao Yung; Hong, Ming Yuan; Lee, Chung Hsun; Tang, Hung Jen; Ko, Wen Chien.
於: International journal of antimicrobial agents, 卷 54, 編號 2, 08.2019, p. 176-183.研究成果: Article
TY - JOUR
T1 - Short versus long duration antimicrobial treatment for community-onset bacteraemia
T2 - A propensity score matching study
AU - Lee, Ching Chi
AU - Hsieh, Chih Chia
AU - Yang, Chao Yung
AU - Hong, Ming Yuan
AU - Lee, Chung Hsun
AU - Tang, Hung Jen
AU - Ko, Wen Chien
PY - 2019/8
Y1 - 2019/8
N2 - The efficacy and safety of short-course intravenous (i.v.) antimicrobial therapy for bloodstream infections is unknown. Therefore, a retrospective 8-year cohort study including 1431 hospitalised adults was conducted to compare the outcomes of patients receiving short-course (5–10 days) and long-course (11–16 days) i.v. antibiotic therapy for community-onset bacteraemia. Of 1010 patients who received short-course therapy, 726 were matched with 363 patients in the long-course group through propensity score matching at a ratio of 1:2 based on independent predictors of 30-day mortality identified in the multivariate regression model. Following appropriate matching, similarities between the two groups in the proportion of baseline characteristics (age, sex, major co-morbidities, co-morbidity severity, bacteraemia severity at onset and major bacteraemia sources) and 30-day crude mortality rate after bacteraemia onset were observed. Notably, clinical outcomes within 30 days after the end of i.v. therapy, in terms of proportions of post-treatment overall infections (2.2% vs. 6.1%; P = 0.001), infections caused by antimicrobial-resistant pathogens (ARPs) (1.7% vs. 4.4%; P = 0.007), and thereby post-treatment crude mortality (1.4% vs. 3.6%; P = 0.009), were lower in the short-course group. In conclusion, for adults with community-onset uncomplicated bacteraemia, short-course (5–10 days) i.v. antibiotic treatment did not result in an increased risk of mortality but instead decreased the odds of overall and ARP infections after the treatment course.
AB - The efficacy and safety of short-course intravenous (i.v.) antimicrobial therapy for bloodstream infections is unknown. Therefore, a retrospective 8-year cohort study including 1431 hospitalised adults was conducted to compare the outcomes of patients receiving short-course (5–10 days) and long-course (11–16 days) i.v. antibiotic therapy for community-onset bacteraemia. Of 1010 patients who received short-course therapy, 726 were matched with 363 patients in the long-course group through propensity score matching at a ratio of 1:2 based on independent predictors of 30-day mortality identified in the multivariate regression model. Following appropriate matching, similarities between the two groups in the proportion of baseline characteristics (age, sex, major co-morbidities, co-morbidity severity, bacteraemia severity at onset and major bacteraemia sources) and 30-day crude mortality rate after bacteraemia onset were observed. Notably, clinical outcomes within 30 days after the end of i.v. therapy, in terms of proportions of post-treatment overall infections (2.2% vs. 6.1%; P = 0.001), infections caused by antimicrobial-resistant pathogens (ARPs) (1.7% vs. 4.4%; P = 0.007), and thereby post-treatment crude mortality (1.4% vs. 3.6%; P = 0.009), were lower in the short-course group. In conclusion, for adults with community-onset uncomplicated bacteraemia, short-course (5–10 days) i.v. antibiotic treatment did not result in an increased risk of mortality but instead decreased the odds of overall and ARP infections after the treatment course.
UR - http://www.scopus.com/inward/record.url?scp=85068358107&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068358107&partnerID=8YFLogxK
U2 - 10.1016/j.ijantimicag.2019.05.014
DO - 10.1016/j.ijantimicag.2019.05.014
M3 - Article
C2 - 31108223
AN - SCOPUS:85068358107
VL - 54
SP - 176
EP - 183
JO - International Journal of Antimicrobial Agents
JF - International Journal of Antimicrobial Agents
SN - 0924-8579
IS - 2
ER -