Shorter duration of antibiotic treatment for acute bacteraemic cholangitis with successful biliary drainage: a retrospective cohort study

It has recently been shown that children with early shigellosis are at increased risk of attention deficit/hyperactivity disorder (ADHD). This study aimed to evaluate the association between antibiotic treatment of shigellosis with long-term ADHD rates. A retrospective cohort study was conducted that included all the Leumit Health Services (LHS) enrollees aged 5–18 years between 2000–2018 with a documented Shigella-positive gastroenteritis before the age of 3 years. Of the 5176 children who were positive for Shigella gastroenteritis before the age of 3 years, 972 (18.8%) were treated with antibiotics early (<5 days), 250 (4.8%) were treated late (≥5 days), and 3954 children (76.4%) were not prescribed antibiotics. Late antibiotic treatment was associated with significantly increased rates of ADHD (adjusted OR = 1.61; 95% CI, 1.1–2.3). Early treatment with antibiotics was not associated with increased ADHD rates (adjusted OR = 1.02; 95% CI, 0.8–1.3). In conclusion, late antibiotic treatment of early childhood shigellosis was associated with increased rates of ADHD.

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Three-day antibiotic treatment for acute cholangitis due to choledocholithiasis with successful biliary duct drainage: A single-center retrospective cohort study

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2020.04.074 ◽

2020 ◽

Vol 96 ◽

pp. 343-347 ◽

Cited By ~ 1

Author(s):

Masaaki Satake ◽

Yukihiro Yamaguchi

Keyword(s):

Cohort Study ◽

Antibiotic Treatment ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Acute Cholangitis ◽

Biliary Duct ◽

Single Center

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1049. Outcome and Impact of Empirical Antimicrobial Treatment in Bacteraemia With Bacteroides Species; A Retrospective Cohort Study in a Region of Southern Sweden

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.886 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S313-S313

Author(s):

Johan Tham ◽

Karolina Kalin ◽

Fredrik Resman ◽

Karin Holm

Keyword(s):

Cohort Study ◽

Antibiotic Treatment ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Early Recognition ◽

Antimicrobial Treatment ◽

Bacteroides Species ◽

Appropriate Treatment ◽

Severe Infections ◽

Anaerobic Infections

Abstract Background Anaerobic infections are an important cause of bacteremia and severe Infections. Due to increasing extended spectrum β-lactamase resistance (ESBL), the treatment recommendations for anaerobic infections in Sweden have changed during the past ten years. The effects of anaerobe resistance and outcome for patients with anaerobe infections is unclear. Methods A retrospective cohort study was conducted in patients with bacteraemia due to Bacteroides species in the Region of Skåne between 2011 and 2015. Data on patients were reviewed from medical and microbiological records and we determined the factors associated with 28-day mortality using a multivariate regression model. Results Data on 454 patients were reviewed from medical and microbiological records and 389 (median age, 76 years; male, 54%) met the inclusion criteria. The 28-day all-cause mortality rate was 19% (72/389). Inadequate empirical antibiotic therapy occurred among 182 (47%) patients, and we found a trend toward that inadequate antibiotic treatment increased the 28-day mortality (P = 0.055). The frequency of bacteraemia with Bacteroides increased during the period of time and Bacteroides fragilis was the most common bacteria, 55% (212/389). The resistance against piperacillin/tazobactam was higher than in many other studies and among the different Bacteroides isolates that were resistant to piperacillin/tazobactam, Bacteroides thetaiotamicron was the most prevalent with 60% (50/83) being resistant. Piperacillin/tazobactam was the frequently used antimicrobial agent against Bacteroides infections and the utilization was increasing. We did not find any resistance among the Bacteroides isolates against metronidazole and only three isolates were resistant against carbapenems. Conclusion Anaerobe resistance is an increasing issue and especially against the most common antibiotic treatment, piperacillin/tazobactam. Early recognition and appropriate treatment is important to avoid proliferation of these increasing bacteria since inadequate treatment increased the mortality. Disclosures All authors: No reported disclosures.

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Use of long-term antibiotic treatment in COPD patients in the UK: a retrospective cohort study

Primary Care Respiratory Journal ◽

10.4104/pcrj.2013.00061 ◽

2013 ◽

Vol 22 (3) ◽

pp. 271-277 ◽

Cited By ~ 16

Author(s):

Gareth Dean Russell James ◽

Irene Petersen ◽

Irwin Nazareth ◽

Jadwiga A Wedzicha ◽

Gavin C Donaldson

Keyword(s):

Cohort Study ◽

Antibiotic Treatment ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Copd Patients ◽

The Uk

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Long-term Outcome of Patients with Acute Cholecystitis Receiving Antibiotic Treatment: A Retrospective Cohort Study

World Journal of Surgery ◽

10.1007/s00268-013-2344-7 ◽

2013 ◽

Vol 38 (2) ◽

pp. 355-356 ◽

Cited By ~ 1

Author(s):

Paul N. Rogers

Keyword(s):

Cohort Study ◽

Acute Cholecystitis ◽

Antibiotic Treatment ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Term Outcome ◽

Long Term Outcome

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Duration of Antibiotic Therapy for Critically Ill Patients with Bloodstream Infections: A Retrospective Cohort Study

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2013/141989 ◽

2013 ◽

Vol 24 (3) ◽

pp. 129-137 ◽

Cited By ~ 22

Author(s):

Thomas C Havey ◽

Robert A Fowler ◽

Ruxandra Pinto ◽

Marion Elligsen ◽

Nick Daneman

Keyword(s):

Cohort Study ◽

Bloodstream Infection ◽

Critically Ill ◽

Antibiotic Treatment ◽

Retrospective Cohort Study ◽

Critically Ill Patients ◽

Retrospective Cohort ◽

Bloodstream Infections ◽

Prolonged Treatment ◽

Care Hospital

BACKGROUND: The optimal duration of antibiotic treatment for bloodstream infections is unknown and understudied.METHODS: A retrospective cohort study of critically ill patients with bloodstream infections diagnosed in a tertiary care hospital between March 1, 2010 and March 31, 2011 was undertaken. The impact of patient, pathogen and infectious syndrome characteristics on selection of shorter (≤10 days) or longer (>10 days) treatment duration, and on the number of antibiotic-free days, was examined. The time profile of clinical response was evaluated over the first 14 days of treatment. Relapse, secondary infection and mortality rates were compared between those receiving shorter or longer treatment.RESULTS: Among 100 critically ill patients with bloodstream infection, the median duration of antibiotic treatment was 11 days, but was highly variable (interquartile range 4.5 to 17 days). Predictors of longer treatment (fewer antibiotic-free days) included foci with established requirements for prolonged treatment, underlying respiratory tract focus, and infection withStaphylococcus aureusorPseudomonasspecies. Predictors of shorter treatment (more antibiotic-free days) included vascular catheter source and bacteremia with coagulase-negative staphylococci. Temperature improvements plateaued after the first week; white blood cell counts, multiple organ dysfunction scores and vasopressor dependence continued to decline into the second week. Among 72 patients who survived to 10 days, clinical outcomes were similar between those receiving shorter and longer treatment.CONCLUSION: Antibiotic treatment durations for patients with bloodstream infection are highly variable and often prolonged. A randomized trial is needed to determine the duration of treatment that will maximize cure while minimizing adverse consequences of antibiotics.

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