Length of Intravenous Antibiotic Therapy and Treatment Failure in Infants With Urinary Tract Infections

Abstract Background The optimal duration of intravenous antibiotic therapy in Staphylococcus aureus prosthetic bone and joint infection has not been established. The objective of this study was to compare the effect of early and late intravenous-to-oral antibiotic switch on treatment failure. Patients and methods We retrospectively analyzed all adult cases of S. aureus prosthetic bone and joint or orthopedic metalware-associated infection between January 2008 and December 2015 in a French university hospital. The primary outcome was treatment failure defined as the recurrence of S. aureus prosthetic bone and joint or orthopedic metalware-associated infection at any time during or after the first line of medical and surgical treatment within 2 years of follow-up. A Cox model was created to assess risk factors for treatment failure. Results Among the 140 patients included, mean age was 60.4 years (SD 20.2), and 66% were male (n = 92). Most infections were due to methicillin-susceptible S. aureus (n = 113, 81%). The mean duration of intravenous antibiotic treatment was 4.1 days (SD 4.6). The majority of patients (119, 85%) had ≤5 days of intravenous therapy. Twelve patients (8.5%) experienced treatment failure. Methicillin-resistant S. aureus infections (HR 11.1; 95% CI 1.5–111.1; p = 0.02), obesity (BMI > 30 kg/m2) (HR 6.9; 95% CI1.4–34.4, p = 0.02) and non-conventional empiric antibiotic therapy (HR 7.1; 95% CI 1.8–25.2; p = 0.005) were significantly associated with treatment failure, whereas duration of intravenous antibiotic therapy (≤ 5 or > 5 days) was not. Conclusion There was a low treatment failure rate in patients with S. aureus prosthetic bone and joint or orthopedic metalware-associated infection with early oral switch from intravenous to oral antibiotic therapy.

Download Full-text

Urinary Excretion of Beta-2-Microglobulin and Albumin During Antibiotic Therapy in Urinary Tract Infections

Urinary Proteins - Contributions to Nephrology ◽

10.1159/000396103 ◽

2015 ◽

pp. 42-49 ◽

Cited By ~ 3

Author(s):

F. P. Schena ◽

R. De Cesaris ◽

A. Tedesco ◽

E. La Raia ◽

L. Bonomo

Keyword(s):

Urinary Tract ◽

Antibiotic Therapy ◽

Urinary Excretion ◽

Urinary Tract Infections ◽

Beta 2 ◽

Beta 2 Microglobulin ◽

Tract Infections

Download Full-text

Obstetric and Gynecologic Issues Related to Infectious Diseases

Mayo Clinic Infectious Diseases Board Review ◽

10.1093/med/9780199827626.003.0041 ◽

2012 ◽

pp. 464-484

Author(s):

Kristi L. Boldt

Keyword(s):

Urinary Tract ◽

Antibiotic Therapy ◽

Urinary Tract Infections ◽

Antimicrobial Therapy ◽

Placental Transfer ◽

Serum Levels ◽

Common Complication ◽

Excretion In Milk ◽

Tract Infections ◽

Preterm Rupture Of Membranes

Infection is the most common complication during pregnancy and the postpartum period. Choices are limited for antibiotic therapy are limited. One must take into account the effect of pregnancy on serum levels, distribution of antibiotics, placental transfer, the fetus, the newborn, excretion in milk, the breast-feeding infant. Antimicrobial therapy is selected on the basis of experience and guidelines. Diagnosis and treatment of urinary tract infections, bacterial vaginosis, preterm labor, preterm rupture of membranes, intra-amniotic infection, and major perinatal and puerperal infections are reviewed.

Download Full-text