Short-course antibiotic therapy okay for Pseudomonas bloodstream infections in febrile neutropenia

Based on previous studies, short-course antibiotic therapy was effective in Pseudomonas aeruginosa (PA) bloodstream infections (BSI) in immunocompetent patients.

The cohort study involved patients with onco-hematology conditions at two hematology centres in China. To eliminate confounding factors, inverse probability of treatment weighting was utilized. A multivariate regression model was then employed to determine the impact of short-course antibiotic therapy on clinical outcomes.

Key findings of this study are:

• Four hundred thirty-four patients met the eligibility criteria.
• The short course was 7-11 days in 229 cases, and the prolonged course was 12-21 days in 205 patients.
• Short-course antibiotic therapy had similar outcomes to the prolonged course.
• Eight patients (3.9%) in the short-course group and ten patients (4.9%) in the prolonged-course group experienced a recurrent PA infectiona at any site or mortality within 30 days of completing therapy.
• The recurrent infection within 90 days occurred in 9.8% and 6.3 % of patients in the short- and prolonged-course groups.
• Seventeen patients in the short-course group and 15 in the prolonged-course group had recurrent fever within seven days.
• Patients on short-course antibiotic therapy spent 3.3 fewer days in the hospital.

Short-course therapy was non-inferior to prolonged-course therapy in terms of clinical outcomes.

They mentioned due to limitations and bias; further investigations are warranted to generalize findings.

Reference:

Xiaomeng Feng et al. Is short-course antibiotic therapy suitable for Pseudomonas aeruginosa bloodstream infections in onco-hematology patients with febrile neutropenia? Results of a multi-institutional analysis, Clinical Infectious Diseases, 2023; ciad605, https://doi.org/10.1093/cid/ciad605