scholarly journals Comparing the Outcomes of Adults With Enterobacteriaceae Bacteremia Receiving Short-Course Versus Prolonged-Course Antibiotic Therapy in a Multicenter, Propensity Score–Matched Cohort

2017 ◽  
Vol 66 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Darunee Chotiprasitsakul ◽  
Jennifer H Han ◽  
Sara E Cosgrove ◽  
Anthony D Harris ◽  
Ebbing Lautenbach ◽  
...  
Keyword(s):  
Propensity Score ◽  
Antibiotic Therapy ◽  
Matched Cohort ◽  
Short Course

scholarly journals Antibiotic Therapy for Pseudomonas aeruginosa Bloodstream Infections: How Long Is Long Enough?

2019 ◽  
Vol 69 (11) ◽  
pp. 2011-2014 ◽  
Author(s):  
Valeria Fabre ◽  
Joe Amoah ◽  
Sara E Cosgrove ◽  
Pranita D Tamma
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Propensity Score ◽  
Antibiotic Therapy ◽  
Recurrent Infection ◽  
Bloodstream Infections ◽  
Interquartile Range ◽  
Short Course

Abstract In a multicenter, observational, propensity-score–weighted cohort of 249 adults with uncomplicated Pseudomonas aeruginosa bacteremia, patients receiving short-course (median, 9 days; interquartile range [IQR], 8–10) therapy had a similar odds of recurrent infection or death within 30 days as those receiving longer courses (median, 16 days; IQR, 14–17).

scholarly journals 212. Outcomes of Adults with Uncomplicated Staphylococcus aureus Bacteremia Receiving Short-Course Vs. Prolonged-Course Antibiotic Therapy in a Multicenter, Propensity Score–Matched Cohort

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S125-S126
Author(s):  
Louise Thorlacius-Ussing ◽  
Jette Nissen ◽  
Jon J Rasmussen ◽  
Robert Skov ◽  
Magnus Arpi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Propensity Score ◽  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Nearest Neighbor ◽  
Bloodstream Infections ◽  
Staphylococcus Aureus Bacteremia ◽  
Short Course ◽  
Short Courses

Abstract Background The recommended duration of antibiotic treatment for uncomplicated Staphylococcus aureus bloodstream infections is 14 days. We compared the outcomes of patients receiving short-course (6–10 days) vs. prolonged-course (11–16 days) antibiotic therapy for S. aureus bacteremia (SAB). Methods 30-day outcome of patients with penicillin (PSSAB, n = 202)) or methicillin-susceptible SAB (MSSAB, n = 203) treated with in vitro active therapy in the range of 6–16 days was analyzed using pooled data from two previously published, observational studies. Individuals were matched 1:1 by nearest neighbor propensity score matching without replacement. Regression analysis was performed to estimate the risk of all-cause mortality within 30 days after the end of antibiotic treatment. Eligible individuals had to have >1 day of follow-up after discontinuation of antimicrobials. Individuals with a diagnosis of endocarditis, bone infection, meningitis or pneumonia were excluded. Results There were 107 well-balanced matched pairs; 58 in the PSSAB and 39 in the MSSAB cohort. For PSSAB, the median duration of therapy was 8 (interquartile range [IQR], 7–10) in the short-course group and 12 days (IQR, 10–13) in the prolonged-course group. For the MSSAB cohort, these numbers were 9 days (IQR, 7–10) and 14 days (IQR, 13–16 days), respectively. No difference in mortality between short-course and prolonged-course treatment was observed (adjusted hazard ratio [aHR], 0.74; 95% confidence interval [CI], .23–2.41) and 1.14; 95% CI, 0.31–4.20), respectively for PSSAB and MSSAB. Conclusion Short courses of antibiotic therapy yielded similar clinical outcomes as prolonged courses of antibiotic therapy for S. aureus bacteremia. The findings warrant a randomized clinical trial to study the safety and efficacy of shortened antimicrobial therapy for the treatment of uncomplicated SAB. Disclosures All authors: No reported disclosures.

scholarly journals Impairment of Validity of Comparison Between Short-Course and Prolonged-Course Antibiotic Therapy Using Propensity Score Matching

2018 ◽  
Vol 66 (12) ◽  
pp. 1978-1978 ◽  
Author(s):  
Kentaro Tochitani ◽  
Tatsuyoshi Ikenoue ◽  
Shungo Yamamoto ◽  
Yosuke Yamamoto
Keyword(s):  
Propensity Score ◽  
Antibiotic Therapy ◽  
Propensity Score Matching ◽  
Short Course

scholarly journals Attributable mortality of vancomycin resistance in ampicillin-resistant Enterococcus faecium bacteremia in Denmark and the Netherlands: A matched cohort study

2021 ◽  
pp. 1-9
Author(s):  
Wouter C. Rottier ◽  
Mette Pinholt ◽  
Akke K. van der Bij ◽  
Magnus Arpi ◽  
Sybrandus N. Blank ◽  
...  
Keyword(s):  
Cohort Study ◽  
The Netherlands ◽  
Antibiotic Therapy ◽  
Enterococcus Faecium ◽  
Mortality Rates ◽  
Vancomycin Resistance ◽  
Attributable Mortality ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
The Impact

Abstract Objective: To study whether replacement of nosocomial ampicillin-resistant Enterococcus faecium (ARE) clones by vancomycin-resistant E. faecium (VRE), belonging to the same genetic lineages, increases mortality in patients with E. faecium bacteremia, and to evaluate whether any such increase is mediated by a delay in appropriate antibiotic therapy. Design: Retrospective, matched-cohort study. Setting: The study included 20 Dutch and Danish hospitals from 2009 to 2014. Patients: Within the study period, 63 patients with VRE bacteremia (36 Dutch and 27 Danish) were identified and subsequently matched to 234 patients with ARE bacteremia (130 Dutch and 104 Danish) for hospital, ward, length of hospital stay prior to bacteremia, and age. For all patients, 30-day mortality after bacteremia onset was assessed. Methods: The risk ratio (RR) reflecting the impact of vancomycin resistance on 30-day mortality was estimated using Cox regression with further analytic control for confounding factors. Results: The 30-day mortality rates were 27% and 38% for ARE in the Netherlands and Denmark, respectively, and the 30-day mortality rates were 33% and 48% for VRE in these respective countries. The adjusted RR for 30-day mortality for VRE was 1.54 (95% confidence interval, 1.06–2.25). Although appropriate antibiotic therapy was initiated later for VRE than for ARE bacteremia, further analysis did not reveal mediation of the increased mortality risk. Conclusions: Compared to ARE bacteremia, VRE bacteremia was associated with higher 30-day mortality. One explanation for this association would be increased virulence of VRE, although both phenotypes belong to the same well-characterized core genomic lineage. Alternatively, it may be the result of unmeasured confounding.

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