Bahrs, Christina and Rieg, Siegbert and Hennigs, Annette and Hitzenbichler, Florian and Brehm, Thomas T. and Rose, Norman and Jacobi, Rebecca J. and Heine, Valerie and Hornuss, Daniel and Huppertz, Gunnar and Hagel, Stefan and Hanses, Frank (2023) Short-course versus long-course antibiotic treatment for uncomplicated vancomycin-resistant enterococcal bacteraemia: a retrospective multicentre cohort study. CLINICAL MICROBIOLOGY AND INFECTION, 29 (2). pp. 200-207. ISSN 1198-743X, 1469-0691
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Objectives: The optimal treatment duration for vancomycin-resistant enterococcal (VRE) bacteraemia is still a matter of debate. The aim of the present study was to compare short-course (<= 9 days) and long -course (>= 10 days) antibiotic treatments in hospitalized adult patients with uncomplicated VRE bacteraemia. Methods: This retrospective study was conducted in four university hospitals in Germany. Adult patients with a positive blood culture for a VRE were screened from 1 January 2016 to 31 December 2018. Only patients who received a VRE-active antibiotic for at least 48 hours were included. The exclusion criteria were a survival of <10 days and a deep-seated source of infection requiring prolonged treatment. To compare the outcome of short-course therapy with that of long-course therapy, 30-day and 90-day overall mortality, relapse within 90 days, duration of hospitalization, and potential antibiotic-related adverse events were analysed by inverse probability of treatment weighting using the propensity score and by additional covariate adjustment. Results: Of the 363 patients screened, 219 (60.3%) patients were included in the final analysis. Among them, 48 (21.9%) patients had underlying haematological diseases. Seventy-eight (35.6%) patients received short-course treatment (median, 7 days; interquartile range, 5-8 days) and 141 (64.4%) patients received long-course treatment (median, 15 days; interquartile range, 12-23.5 days). Thirty-day mor-tality was similar in both groups (19.2% vs. 22.0%; adjusted OR, 1.15; p 0.773). Duration of hospitalization (in total and after onset of bacteraemia) was significantly shorter (p < 0.05) in the short-course treatment group, whereas other secondary outcome parameters did not differ between both groups. Discussion: Our study suggests that short-course treatment might not be associated with a worse outcome in patients with uncomplicated VRE bacteraemia. Christina Bahrs, Clin Microbiol Infect 2023;29:200 (c) 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PRIMER; Bloodstream infection; Daptomycin; Mortality; Relapse; Vancomycin-resistant Enterococcus; Linezolid |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien Medicine > Abteilung für Krankenhaushygiene und Infektiologie Medicine > Notfallambulanz |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 31 Jan 2024 07:03 |
| Last Modified: | 31 Jan 2024 07:03 |
| URI: | https://pred.uni-regensburg.de/id/eprint/59908 |
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