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🌱 來自: Huppert’s Notes
Gram-Negative Bacteremia🚧 施工中
Gram-Negative Bacteremia
• Seven versus 14 days of antibiotic therapy for uncomplicated Gram-negative bacteremia : A noninferiority randomized controlled trial. Clin Infect Dis 2019;9(7):1091–1098.
- This is a randomized, multicenter, open-label, noninferiority trial that evaluated 7 vs. 14 days of antibiotics for Gram-negative bacteremia in patients who were afebrile and hemodynamically stable for 48 hours without an uncontrolled focus of infection. 7 days was not inferior to 14 days based on all-cause mortality. This study supports the practice change towards shorter courses of antibiotics for uncomplicated Gram-negative bacteremia.
• Association of 30-day mortality with oral step-down vs continued intravenous therapy in patients hospitalized with Enterobacteriaceae bacteremia. JAMA Intern Med 2019;179(3):316–323.
- This retrospective multicenter cohort study included 4967 unique propensity score-matched patients hospitalized with monomicrobial Enterobacteriaceae bacteremia. It compared patients treated with oral step-down therapy within the first 5 days of treatment with those treated with continuous intravenous antibiotics. 30-day mortality was not different among the groups, which suggests that oral step-down therapy may be effective in patients with adequate source control and clinical response to initial therapy. It’s important to note that most patients received either a quinolone or trimethoprim-sulfamethoxazole. Oral beta-lactams were not thoroughly evaluated.