AI Article Synopsis
- - The study investigates whether it's safe to shorten intravenous antibiotic treatment for methicillin-sensitive bacteraemia (MS-SAB), which usually requires long courses of therapy.
- - In a review of 281 adult MS-SAB cases, 74% achieved a successful outcome, and many patients (63%) received less than 14 days of intravenous therapy without significant issues.
- - Results highlight that while very short intravenous treatments (<7 days) increased the risk of recurrence, switching to oral antibiotics could effectively reduce the duration of intravenous therapy without compromising safety, especially if CRP levels decreased significantly.
Article Abstract
Objectives: Long courses of intravenous antimicrobial therapy are traditionally recommended for the treatment of methicillin sensitive bacteraemia (MS-SAB), but are not always completed in clinical practice. Early intravenous to oral antibiotic switch is a key component of antimicrobial stewardship. This study aimed to identify whether intravenous antibiotic duration may be safely reduced in MS-SAB.
Methods: We performed a single-centre retrospective study of MS-SAB management. Successful outcome was defined as 90-day recurrence-free survival. Effect of intravenous antibiotic duration on 90-day recurrence risk was examined.
Results: 281 adult cases of MS-SAB were evaluated, of which 208 (74%) had a successful outcome. 176 cases (63%) received less than 14 days of intravenous antimicrobial therapy. Very short durations of intravenous therapy were associated with increased risk of recurrence (<7 days iv, 9.8% recurrence; 7-13 days, 1.4%; ≥14 days, 2.9%; p 0.005). This effect was robust to sensitivity analysis for total antimicrobial therapy duration of 14 days. CRP reduction of at least 37% from peak value at intravenous to oral antibiotic switch was associated with decreased risk of recurrence (<37% CRP reduction, 12% recurrence; >37%, 2.0%; p 0.001).
Conclusions: Oral antimicrobial switch may allow safe reductions in duration of intravenous therapy in MS-SAB.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613828 | PMC |
| http://dx.doi.org/10.1016/j.clinpr.2022.100202 | DOI Listing |
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