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- Title
Impact of duration of antibiotic therapy in central venous catheter-related bloodstream infection due to Gram-negative bacilli.
- Authors
Ruiz-Ruigómez, María; Fernández-Ruiz, Mario; San-Juan, Rafael; López-Medrano, Francisco; Orellana, María Ángeles; Corbella, Laura; Rodríguez-Goncer, Isabel; Jiménez, Pilar Hernández; Aguado, José María; Hernández Jiménez, Pilar
- Abstract
<bold>Background: </bold>A progressive increase in the incidence of catheter-related bloodstream infection (CRBSI) due to Gram-negative bacilli (GNB) has been reported. Current guidelines recommend antibiotic treatment for at least 7-14 days, although the supporting evidence is limited.<bold>Methods: </bold>We performed a retrospective single-centre study including all patients with a definite diagnosis of GNB CRBSI from January 2012 to October 2018 in which the central venous catheter (CVC) was removed. The occurrence of therapeutic failure [clinical failure (persistence of symptoms and laboratory signs of infection), microbiological failure (persistent bacteraemia or relapse) and/or all-cause 30 day mortality] was compared between episodes receiving short [≤7 days (SC)] or long courses [>7 days (LC)] of appropriate antibiotic therapy following CVC removal.<bold>Results: </bold>We included 54 GNB CRBSI episodes with an overall rate of therapeutic failure of 27.8% (15/54). Episodes receiving SC therapy were more frequently due to MDR GNB [60.9% (14/23) versus 34.5% (10/29); P = 0.058] and had higher Pitt scores [median (IQR) 1 (0-4) versus 0 (0-2); P = 0.086]. There were no significant differences in the rate of therapeutic failure between episodes treated with SC or LC therapy [30.4% (7/23) versus 27.6% (8/29); OR 1.15; 95% CI 0.34-3.83; P = 0.822]. The use of SCs was not associated with increased odds of therapeutic failure in any of the exploratory models performed.<bold>Conclusions: </bold>The administration of appropriate antibiotic therapy for ≤7 days may be as safe and effective as longer courses in episodes of GNB CRBSI once the CVC has been removed.
- Subjects
CATHETER-related infections; TREATMENT duration; CENTRAL venous catheters; SYMPTOMS; BACTEREMIA; ANTIBIOTICS; RESEARCH; CENTRAL venous catheterization; RESEARCH methodology; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2020, Vol 75, Issue 10, p3049
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkaa244