Cure Rate of Intra-Abdominal Infection With Short vs Prolonged Therapy

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SAN FRANCISCO — No significant differences in clinical cure rates were observed between short-course and prolonged-course antimicrobial therapy in patients with intra-abdominal infection, according to data presented at IDWeek 2018, held October 3 to 7, 2018, in San Francisco, California.

An Institutional Review Board-approved single-center, retrospective cohort study included 175 patients admitted to the University of Toledo Medical Center from January 1, 2012, to June 30, 2017, with intra-abdominal infection. Participants received antimicrobial medication for ≥48 hours and had at least 1 sign of intra-abdominal infection. Of the total patients, 73 received a short course (≤7 days of antimicrobial treatment) and 102 patients received a prolonged course (>7 days of antimicrobial treatment).

Baseline characteristics were similar between treatment groups and the rate of clinical cure for short course vs prolonged course was 74.0% vs 67.6% (P =.367). No secondary outcomes in short course vs prolonged course, such as hospital length of stay (5.5 days vs 5.8 days, P =.372), length of stay in the intensive care unit (3.0 days vs 5.0 days, P =.117), 28-day all-cause mortality (4.1% vs 2.0%, P =.651), or 30-day readmission (19.2% vs 20.6%, P =.818) were significant. Diverticulitis was the only variable independently associated with clinical cure after multivariable logistic regression (adjusted odds ratio .337; 95% CI, .133-.853).

Investigators concluded that these results further support the Infectious Disease Society of America’s recommendation of shorter therapy duration for intra-abdominal infection. The current guidelines recommend treatment length of 4 to 7 days; however, antimicrobial medications are still often administered for 10 to 14 days.

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Reference

Phlamon M, Petite S, Cole, K. Comparison of short-course versus prolonged-course antimicrobial therapy in the management of intra-abdominal infections. Presented at: IDWeek 2018; October 3-7, 2018; San Francisco, CA. Abstract 1116.