Potential Excess Intravenous Antibiotic Therapy in the Setting of Gram-Negative Bacteremia
(1) Background: Excessive intravenous therapy (EIV) is associated with negative consequences, but guidelines are unclear about when switching to oral therapy is appropriate. (2) Methods: This cohort included patients aged ≥18 years receiving ≥48 h of antimicrobial therapy for bacteremia due to <i...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Pharmacy |
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| Online Access: | https://www.mdpi.com/2226-4787/9/3/133 |
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| author | Ashley R. Selby Jaffar Raza Duong Nguyen Ronald G. Hall 2nd |
| author_facet | Ashley R. Selby Jaffar Raza Duong Nguyen Ronald G. Hall 2nd |
| author_sort | Ashley R. Selby |
| collection | DOAJ |
| description | (1) Background: Excessive intravenous therapy (EIV) is associated with negative consequences, but guidelines are unclear about when switching to oral therapy is appropriate. (2) Methods: This cohort included patients aged ≥18 years receiving ≥48 h of antimicrobial therapy for bacteremia due to <i>Escherichia coli</i>, <i>Pseudomonas aeruginosa</i>, Enterobacter, Klebsiella, Acinetobacter, or <i>Stenotrophomonas maltophilia</i> from 1/01/2008–8/31/2011. Patients with a polymicrobial infection or recurrent bacteremia were excluded. Potential EIV (PEIV) was defined as days of intravenous antibiotic therapy beyond having a normal WBC count for 24 h and being afebrile for 48 h until discharge or death. (3) Results: Sixty-nine percent of patients had PEIV. Patients who received PEIV were more likely to receive intravenous therapy until discharge (46 vs. 16%, <i>p</i> < 0.001). Receipt of PEIV was associated with a longer mean time to receiving oral antimicrobials (8.7 vs. 3 days, <i>p</i> < 0.001). The only factors that impacted EIV days in the multivariable linear regression model were the source of infection (urinary tract) (coefficient −1.54, 95%CI −2.82 to −0.26) and Pitt bacteremia score (coefficient 0.51, 95%CI 0.10 to 0.92). (4) Conclusions: PEIV is common in inpatients with Gram-negative bacteremia. Clinicians should look to avoid PEIV in the inpatient setting. |
| first_indexed | 2024-03-10T07:18:12Z |
| format | Article |
| id | doaj.art-466d617f452f45b186aeb4814c5d277d |
| institution | Directory Open Access Journal |
| issn | 2226-4787 |
| language | English |
| last_indexed | 2024-03-10T07:18:12Z |
| publishDate | 2021-08-01 |
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| record_format | Article |
| series | Pharmacy |
| spelling | doaj.art-466d617f452f45b186aeb4814c5d277d2023-11-22T14:49:18ZengMDPI AGPharmacy2226-47872021-08-019313310.3390/pharmacy9030133Potential Excess Intravenous Antibiotic Therapy in the Setting of Gram-Negative BacteremiaAshley R. Selby0Jaffar Raza1Duong Nguyen2Ronald G. Hall 2nd3Department of Pharmacy Practice, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, TX 75235, USADepartment of Pharmacy Practice, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, TX 75235, USADepartment of Pharmacy Practice, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, TX 75235, USADepartment of Pharmacy Practice, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, TX 75235, USA(1) Background: Excessive intravenous therapy (EIV) is associated with negative consequences, but guidelines are unclear about when switching to oral therapy is appropriate. (2) Methods: This cohort included patients aged ≥18 years receiving ≥48 h of antimicrobial therapy for bacteremia due to <i>Escherichia coli</i>, <i>Pseudomonas aeruginosa</i>, Enterobacter, Klebsiella, Acinetobacter, or <i>Stenotrophomonas maltophilia</i> from 1/01/2008–8/31/2011. Patients with a polymicrobial infection or recurrent bacteremia were excluded. Potential EIV (PEIV) was defined as days of intravenous antibiotic therapy beyond having a normal WBC count for 24 h and being afebrile for 48 h until discharge or death. (3) Results: Sixty-nine percent of patients had PEIV. Patients who received PEIV were more likely to receive intravenous therapy until discharge (46 vs. 16%, <i>p</i> < 0.001). Receipt of PEIV was associated with a longer mean time to receiving oral antimicrobials (8.7 vs. 3 days, <i>p</i> < 0.001). The only factors that impacted EIV days in the multivariable linear regression model were the source of infection (urinary tract) (coefficient −1.54, 95%CI −2.82 to −0.26) and Pitt bacteremia score (coefficient 0.51, 95%CI 0.10 to 0.92). (4) Conclusions: PEIV is common in inpatients with Gram-negative bacteremia. Clinicians should look to avoid PEIV in the inpatient setting.https://www.mdpi.com/2226-4787/9/3/133antibioticanti-bacterial agentantimicrobialGram-negativedurationbacteremia |
| spellingShingle | Ashley R. Selby Jaffar Raza Duong Nguyen Ronald G. Hall 2nd Potential Excess Intravenous Antibiotic Therapy in the Setting of Gram-Negative Bacteremia Pharmacy antibiotic anti-bacterial agent antimicrobial Gram-negative duration bacteremia |
| title | Potential Excess Intravenous Antibiotic Therapy in the Setting of Gram-Negative Bacteremia |
| title_full | Potential Excess Intravenous Antibiotic Therapy in the Setting of Gram-Negative Bacteremia |
| title_fullStr | Potential Excess Intravenous Antibiotic Therapy in the Setting of Gram-Negative Bacteremia |
| title_full_unstemmed | Potential Excess Intravenous Antibiotic Therapy in the Setting of Gram-Negative Bacteremia |
| title_short | Potential Excess Intravenous Antibiotic Therapy in the Setting of Gram-Negative Bacteremia |
| title_sort | potential excess intravenous antibiotic therapy in the setting of gram negative bacteremia |
| topic | antibiotic anti-bacterial agent antimicrobial Gram-negative duration bacteremia |
| url | https://www.mdpi.com/2226-4787/9/3/133 |
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