A short course of antibiotic therapy (SC) showed no difference in mortality for 90 days compared with prolonged antibiotic therapy (PC) in low-risk methicillin-sensitive patients. Staphylococcus aureus Bacteremia, according to the results of a multicenter and retrospective cohort study published in Clinical infectious diseases.
The investigators recruited 3 groups of patients Aureus Bacteremia over more than two decades in Copenhagen, Denmark. From January 1 2009 to December 31, 2018, the first group consisted of 645 patients, of whom 166 underwent SC treatment and 479 underwent computer therapy. From January 1, 2006 to December 31, 2008, the second group consisted of 219 patients, of whom 74 underwent SC treatment and 145 who underwent computer therapy. From January 1, 1995 to December 31, 2010, the third group consisted of 197 patients of whom 51 underwent SC treatment and 90 underwent computer therapy.
SC treatment was defined as 6 to 10 days of treatment, and PC therapy was defined as 11 to 16 days of treatment. In Cohort 1, relapse was defined as the identification of a deep-seated or new infection Aureus Bacteremia that occurs within 90 days of finishing antibiotic treatment. The primary outcome of this study was death from any cause within 90 days of antibiotic treatment.
In the first cohort, 32 of 166 (19.3%) patients in the SC group and 91 of 479 (19.0%) patients in the PC group died within 90 days of termination of antibiotic therapy. There was no significant difference in the initial score between groups in the raw (odds ratio [OR], 1.02; 95% CI, 0.65-1.59) or weighted (OR, 0.85; 95% CI, 0.49-1.41).
In the placebo group, 17 of 74 (23.0%) patients in the SC group and 30 of 145 (20.7%) patients in the PC group died within 90 days of termination of antibiotic treatment. There was no significant difference in the primary outcome between groups in the raw model (OR, 1.14; 95% CI, 0.58-2.24) or weighted (OR, 1.24; 95% CI, 0.60-2.62).
In cohort 3, 9 of 51 (17.6%) patients in the SC group and 18 of 90 (20.0%) patients in the PC group died within 90 days of termination of antibiotic therapy. There was no significant difference in the primary outcome between groups in the raw model (OR, 0.86; 95% CI, 0.35-2.08) or weighted (OR, 1.15; 95% CI, 0.24-4.01).
It was observed that treatment duration was not associated with a 30-day mortality outcome in the sensitivity analysis (OR, 1.03; 95% CI, 0.60-1.65) of the pooled group. Additionally, the study authors stated that further investigations are needed to apply SC therapy for methicillin resistance Aureus Bacteremia.
Exploring the possibility of shortening the duration of antimicrobial therapy is important because it can benefit patients in a number of ways including reducing the risk of adverse events, avoiding microbiome disturbances as well as shortening hospital stay. Moreover, reducing antibiotic use is likely to benefit health. The general public in terms of preventing the development of resistance, “the study authors concluded.
Disclosure: One of the study authors announced his association with the pharmaceutical industry. Please see the original reference for a complete list of author’s disclosures.
Thorlacius-Ussing L, Sandholdt H, Nissen J, et al. Comparable results for short-term and long-term treatment in selected cases of methicillin allergy Staphylococcus aureus Bacteremia: a pooled cohort study. Clen infect dis. Posted online March 2, 2021. doi: 10.1093 / cid / ciab201