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Abstract

Vol.68 No.4 July 2020

Antimicrobial treatment duration and outcomes in patients with bacteremia caused by extended-spectrum β-lactamase-producing Gram-negative bacteria: A single-center retrospective study

Ichiro Nakakura1, 2), Kaori Imanishi1, 2), Kazuyuki Hirota2, 3), Miyuki Tsubokura2), Tomoko Uehira2, 3), Takashi Miyabe1), Rumi Sako1) and Kazutaka Yamauchi1)

1)Department of Pharmacy, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, Japan
2)Department of Infection Control and Prevention, National Hospital Organization Osaka National Hospital
3)Department of Infectious Diseases, National Hospital Organization Osaka National Hospital

Abstract

In patients with bacteremia caused by extended-spectrum β-lactamase-producing Gram-negative bacteria (ESBLs-GNB), the relationship between the treatment duration with antimicrobial drugs and the treatment outcomes has not yet been clarified. The present single-center retrospective study, conducted in 87 patients who had received treatment for ESBLs-GNB bacteremia, was aimed at clarifying this relationship. The primary endpoint was the relationship between the duration of antimicrobial drug treatment and the treatment outcomes (death within 30 days and incidence of recurrent bacteremia). Of the 87 patients, 2 (2%) died within 30 days of completion of treatment with the appropriate antibiotic(s), and 5 (6%) developed recurrent bacteremia. While no association was observed between the treatment duration with the appropriate antibiotic(s) of ≤10 days and the risk of death within 30 days of completion of treatment (P=0.35), the treatment duration with the appropriate antibiotic(s) of ≤10 days was found to be significantly associated with the risk of recurrent bacteremia (P=0.049). In conclusion, our findings revealed that in patients with ESBLs-GNB bacteremia, a treatment duration of ≤10 days, even with the appropriate antibiotic(s), was associated with an elevated risk of recurrent bacteremia.

Key word

extended-spectrum β-lactamase, Gram-negative bacteria, bacteremia, mortality, recurrent

Received

October 11, 2019

Accepted

April 20, 2020

Jpn. J. Chemother. 68 (4): 539-546, 2020