Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible
Data about short courses of antibiotic therapy for Gram-negative bacilli (GNB) bacteremia in immunosuppressed patients are limited. This is a prospective observational study performed on adult patients with cancer and hematopoietic stem cell transplant (HSCT) who developed GNB bacteremia and receive...
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MDPI AG
2023-02-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/11/2/511 |
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| author | Fabián Herrera Diego Torres Alberto Carena Federico Nicola Andrés Rearte Elena Temporiti Laura Jorge Ricardo Valentini Florencia Bues Silvia Relloso Pablo Bonvehí |
| author_facet | Fabián Herrera Diego Torres Alberto Carena Federico Nicola Andrés Rearte Elena Temporiti Laura Jorge Ricardo Valentini Florencia Bues Silvia Relloso Pablo Bonvehí |
| author_sort | Fabián Herrera |
| collection | DOAJ |
| description | Data about short courses of antibiotic therapy for Gram-negative bacilli (GNB) bacteremia in immunosuppressed patients are limited. This is a prospective observational study performed on adult patients with cancer and hematopoietic stem cell transplant (HSCT) who developed GNB bacteremia and received appropriate empirical antibiotic therapy (EAT), had a clinical response within 7 days and survived 48 h after the end of therapy. They received antibiotic therapy in the range of 7–15 days and were divided into short course, with a median of 7 days (SC), or long course, with a median of 14 days (LC). Seventy-four patients were included (SC: 36 and LC: 38). No differences were observed in baseline characteristics or in the presence of neutropenia: 58.3% vs. 60.5% (<i>p</i> = 0.84). Clinical presentation and microbiological characteristics were similar in SC and LC, respectively: clinical source of bacteremia 72.2% vs. 76.3% (<i>p</i> = 0.68); shock 2.8% vs. 10.5% (<i>p</i> = 0.35) and multidrug-resistant GNB 27.8% vs. 21.1% (<i>p</i> = 0.50). Overall, mortality was 2.8% vs. 7.9% (<i>p</i> = 0.61), and bacteremia relapse was 2.8% vs. 0 (<i>p</i> = 0.30). The length of hospitalization since bacteremia was 7 days (interquartile range (IQR), 6–15) for SC and 12 days (IQR, 7–19) (<i>p</i> = 0.021) for LC. In the case of patients with cancer or HSCT and GNB bacteremia who receive appropriate EAT with clinical response, 7 days of antibiotic therapy might be adequate. |
| first_indexed | 2024-03-11T08:23:42Z |
| format | Article |
| id | doaj.art-f3c64657b1fc4e5d8e5e1f27ecb57ffc |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-11T08:23:42Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-f3c64657b1fc4e5d8e5e1f27ecb57ffc2023-11-16T22:16:54ZengMDPI AGMicroorganisms2076-26072023-02-0111251110.3390/microorganisms11020511Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is PossibleFabián Herrera0Diego Torres1Alberto Carena2Federico Nicola3Andrés Rearte4Elena Temporiti5Laura Jorge6Ricardo Valentini7Florencia Bues8Silvia Relloso9Pablo Bonvehí10Infectious Diseases Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaInfectious Diseases Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaInfectious Diseases Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaMicrobiology Laboratory, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaInfectious Diseases Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaInfectious Diseases Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaInfectious Diseases Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaInternal Medicine Department, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaInfectious Diseases Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaMicrobiology Laboratory, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaInfectious Diseases Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1431, ArgentinaData about short courses of antibiotic therapy for Gram-negative bacilli (GNB) bacteremia in immunosuppressed patients are limited. This is a prospective observational study performed on adult patients with cancer and hematopoietic stem cell transplant (HSCT) who developed GNB bacteremia and received appropriate empirical antibiotic therapy (EAT), had a clinical response within 7 days and survived 48 h after the end of therapy. They received antibiotic therapy in the range of 7–15 days and were divided into short course, with a median of 7 days (SC), or long course, with a median of 14 days (LC). Seventy-four patients were included (SC: 36 and LC: 38). No differences were observed in baseline characteristics or in the presence of neutropenia: 58.3% vs. 60.5% (<i>p</i> = 0.84). Clinical presentation and microbiological characteristics were similar in SC and LC, respectively: clinical source of bacteremia 72.2% vs. 76.3% (<i>p</i> = 0.68); shock 2.8% vs. 10.5% (<i>p</i> = 0.35) and multidrug-resistant GNB 27.8% vs. 21.1% (<i>p</i> = 0.50). Overall, mortality was 2.8% vs. 7.9% (<i>p</i> = 0.61), and bacteremia relapse was 2.8% vs. 0 (<i>p</i> = 0.30). The length of hospitalization since bacteremia was 7 days (interquartile range (IQR), 6–15) for SC and 12 days (IQR, 7–19) (<i>p</i> = 0.021) for LC. In the case of patients with cancer or HSCT and GNB bacteremia who receive appropriate EAT with clinical response, 7 days of antibiotic therapy might be adequate.https://www.mdpi.com/2076-2607/11/2/511Gram-negative bacteremiacancershort antibiotic course |
| spellingShingle | Fabián Herrera Diego Torres Alberto Carena Federico Nicola Andrés Rearte Elena Temporiti Laura Jorge Ricardo Valentini Florencia Bues Silvia Relloso Pablo Bonvehí Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible Microorganisms Gram-negative bacteremia cancer short antibiotic course |
| title | Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible |
| title_full | Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible |
| title_fullStr | Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible |
| title_full_unstemmed | Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible |
| title_short | Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible |
| title_sort | short course of antibiotic therapy for gram negative bacilli bacteremia in patients with cancer and hematopoietic stem cell transplantation less is possible |
| topic | Gram-negative bacteremia cancer short antibiotic course |
| url | https://www.mdpi.com/2076-2607/11/2/511 |
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