Short-course antibiotic therapy okay for Pseudomonas bloodstream infections in febrile neutropenia
Antibiotic resistance, gut microbiome disturbances and adverse events have stimulated interest in revisiting standard antibiotic treatment durations. Studies suggest shorter courses may be as effective as longer ones for community-acquired pneumonia, ventilator-associated pneumonia, urinary tract infections, cellulitis, and intra-abdominal infections.
A study published in Clinical Infectious Diseases by Feng et al. and colleagues has concluded that short-course therapy is non-inferior to prolonged-course treatment pertaining to clinical outcomes.
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
