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

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In patients with intra-abdominal infections, there was no significant difference observed in rates of clinical cure between short course and prolonged antimicrobial therapy.
In patients with intra-abdominal infections, there was no significant difference observed in rates of clinical cure between short course and prolonged antimicrobial therapy.
This article is part of Infectious Disease Advisor's coverage of IDWeek 2018, taking place in San Francisco, CA. Our on-site staff will be reporting on the latest breaking research and clinical advances in infectious diseases. Check back regularly for highlights from IDWeek 2018.

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.

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