感染症と治療ジャーナル

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Comparing the Outcomes Associated With Three Treatment Durations for Enterobacteriaceae Bloodstream Infection

Jamal Wadi Al Ramahi, Ayad Abdullah Al-Qadasi, Sewar Saed Fraij, Ahmad Bassam Alayyat, Asma’a Rezeq Tanash, Nour Mohammad Hasan, Amal Matar, Renad Mohammad Khader, Asaiel Zaid Makahleh, Ibraheem Zuhair AR Mohialdeen, Haya Moh’d Hamarsha, Zaid Antwan Tewfiq Al Khouri, Zaid Ali Zuhair Elkarmi, Lara Abdulhadi, Farah A Abdallah

Background: A proper duration for treating patients with Enterobacteriaceae bloodstream infection is not yet well defined; we attempt to find the appropriate course of treatment.

Methods: A retrospective multicenter study in Amman-Jordan. Medical records were reviewed for patients with blood cultures growth for Enterobacteriaceae. Information on blood cultures was extracted from the microbiology logbook and records. For adults >18 years, primary bacteremia and a known source were included. Patients who needed prolonged antibiotics treatment due to the nature of their infections and zoonotic infections, neutropenic cancer patients, organs with abscesses/empyema, CVC retention, polymicrobial septicemia, and expected survival ≤ 48 hours were excluded. Continuous variables were analyzed by (χ²), ANOVA for means, and the Bonferroni for pairwise comparisons if P-value is <0.05.

Results: 323 Patients with Enterobacteriaceae growth on blood cultures were distributed as follows: patients with one-week treatment duration were 163, two-week 102, and three-week duration was 58. Characteristics were balanced among the three durations (P>0.05) except male gender; diabetes, steroids, CVC, and a few antibiotics were more in the three-week treatment (P<0.05). All-cause mortality, relapse, and reinfection did not differ significantly among the three treatment durations (P>0.05). The relapse rate in 90 days was 5.17%, and the reinfection rate was 4.3%.

Conclusion: There was no significant difference in the three antibiotics treatment durations in the 28-day, 90-day all-cause mortality rates, relapse, and reinfection rates.