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Similar outcomes among intra-abdominal infection patients with reduced antimicrobial duration
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Patients with source-controlled intra-abdominal infections given shorter antimicrobial therapy appeared to have similar outcomes to those whose treatment length was not reduced, according to recently published data.
“Currently used guidelines, including those published jointly by the Surgical Infection Society and the Infectious Diseases Society of America, recommend a treatment course of 4 to 7 days, depending on the clinical response,” Robert G. Sawyer, MD, of the University of Virginia Health System, and colleagues wrote. “Despite these recommendations, observational studies show that therapy is typically administered for 10 to 14 days.”
The researchers randomly assigned 518 patients to receive antimicrobial therapy for 3 to 5 days after source-control of an intra-abdominal infection, or to receive treatment until 2 days after the resolution of symptoms related to systemic inflammatory response syndrome for a maximum of 10 days. Primary outcomes included surgical-site infection, recurrent intra-abdominal infection and death within 30 days of source-control procedures. Duration of therapy and subsequent infection rates also were observed.
Robert G. Sawyer
There was no difference in outcomes between patient groups. Primary outcomes were observed in 21.8% of the reduced-treatment group and 22.3% of the control group (absolute difference, –0.5 percentage points; 95% CI, –7 to 8). Median duration of antibiotic therapy was 4 days and 8 days for the reduced and control groups, respectively.
“It’s important for physicians to realize the most important aspect of the management of these patients is controlling the source of infection,” Sawyer said in a press release. “These data certainly suggest that if a good operation is performed, a short course of antibiotics may be all that is required.”
Disclosure: Sawyer reports receiving consulting fees from 3M and Pfizer. Please see the full study for a list of all other authors’ relevant financial disclosures.
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