Duration of Treatment for Pseudomonas aeruginosa Bacteremia: a Retrospective Study

Tanya Babich; Pontus Naucler; John Karlsson Valik; Christian G. Giske; Natividad Benito; Ruben Cardona; Alba Rivera; Celine Pulcini; Manal Abdel Fattah; Justine Haquin; Alasdair Macgowan; Sally Grier; Bibiana Chazan; Anna Yanovskay; Ronen Ben Ami; Michal Landes; Lior Nesher; Adi Zaidman-Shimshovitz; Kate McCarthy; David L. Paterson; Evelina Tacconelli; Michael Buhl; Susanna Mauer; Jesús Rodríguez-Baño; Marina de Cueto; Antonio Oliver; Enrique Ruiz de Gopegui; Angela Cano; Isabel Machuca; Monica Gozalo-Marguello; Luis Martinez-Martinez; Eva M. Gonzalez-Barbera; Iris Gomez Alfaro; Miguel Salavert; Bojana Beovic; Andreja Saje; Manica Mueller–Premru; Leonardo Pagani; Virginie Vitrat; Diamantis Kofteridis; Maria Zacharioudaki; Sofia Maraki; Yulia Weissman; Mical Paul; Yaakov Dickstein; Leonard Leibovici; Dafna Yahav

doi:10.1007/s40121-022-00657-1

Duration of Treatment for Pseudomonas aeruginosa Bacteremia: a Retrospective Study

Tanya Babich, Pontus Naucler, John Karlsson Valik, Christian G. Giske, Natividad Benito, Ruben Cardona, Alba Rivera, Celine Pulcini, Manal Abdel Fattah, Justine Haquin, Alasdair Macgowan, Sally Grier, Bibiana Chazan, Anna Yanovskay, Ronen Ben Ami, Michal Landes, Lior Nesher, Adi Zaidman-Shimshovitz, Kate McCarthy, David L. PatersonEvelina Tacconelli, Michael Buhl, Susanna Mauer, Jesús Rodríguez-Baño, Marina de Cueto, Antonio Oliver, Enrique Ruiz de Gopegui, Angela Cano, Isabel Machuca, Monica Gozalo-Marguello, Luis Martinez-Martinez, Eva M. Gonzalez-Barbera, Iris Gomez Alfaro, Miguel Salavert, Bojana Beovic, Andreja Saje, Manica Mueller–Premru, Leonardo Pagani, Virginie Vitrat, Diamantis Kofteridis, Maria Zacharioudaki, Sofia Maraki, Yulia Weissman, Mical Paul, Yaakov Dickstein, Leonard Leibovici, Dafna Yahav

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Introduction: There is no consensus regarding optimal duration of antibiotic therapy for Pseudomonas aeruginosa bacteremia. We aimed to evaluate the impact of short antibiotic course. Methods: We present a retrospective multicenter study including patients with P. aeruginosa bacteremia during 2009–2015. We evaluated outcomes of patients treated with short (6–10 days) versus long (11–15 days) antibiotic courses. The primary outcome was a composite of 30-day mortality or bacteremia recurrence and/or persistence. Univariate and inverse probability treatment-weighted (IPTW) adjusted multivariate analysis for the primary outcome was performed. To avoid immortal time bias, the landmark method was used. Results: We included 657 patients; 273 received a short antibiotic course and 384 a long course. There was no significant difference in baseline characteristics of patients. The composite primary outcome occurred in 61/384 patients in the long-treatment group (16%) versus 32/273 in the short-treatment group (12%) (p = 0.131). Mortality accounted for 41/384 (11%) versus 25/273 (9%) of cases, respectively. Length of hospital stay was significantly shorter in the short group [median 13 days, interquartile range (IQR) 9–21 days, versus median 15 days, IQR 11–26 days, p = 0.002]. Ten patients in the long group discontinued antibiotic therapy owing to adverse events, compared with none in the short group. On univariate and multivariate analyses, duration of therapy was not associated with the primary outcome. Conclusions: In this retrospective study, 6–10 days of antibiotic course for P. aeruginosa bacteremia were as effective as longer courses in terms of survival and recurrence. Shorter therapy was associated with reduced length of stay and less drug discontinuation.

Original language	English
Pages (from-to)	1505-1519
Number of pages	15
Journal	Infectious Diseases and Therapy
Volume	11
Issue number	4
DOIs	https://doi.org/10.1007/s40121-022-00657-1
State	Published - Aug 2022
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

Funding

No funding or sponsorship was received for this study or publication of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Dafna Yahav, Tanya Babich, and Leonard Leibovici contributed to the study conception and all authors participated in the study’s protocol writing and study design. Material preparation and data collection were performed by all authors. Dafna Yahav, Tanya Babich, and Leonard Leibovici performed the analysis and wrote the first draft of the manuscript. All authors commented on previous versions of the manuscript, and read and approved the final manuscript. Tanya Babich, Pontus Naucler, John Karlsson Valik, Christian G. Giske, Natividad Benito, Ruben Cardona, Alba Rivera, Celine Pulcini, Manal Abdel Fattah, Justine Haquin, Alasdair Macgowan, Sally Grier, Bibiana Chazan, Anna Yanovskay, Ronen Ben Ami, Michal Landes, Lior Nesher, Adi Zaidman-Shimshovitz, Kate McCarthy, David L Paterson, Evelina Tacconelli, Michael Buhl, Susanna Mauer, Jesús Rodríguez-Baño, Marina de Cueto, Antonio Oliver, Enrique Ruiz de Gopegui, Angela Cano, Isabel Machuca, Monica Gozalo-Marguello, Luis Martinez-Martinez, Eva M Gonzalez-Barbera, Iris Gomez Alfaro, Miguel Salavert, Bojana Beovic, Andreja Saje, Manica Mueller–Premru, Leonardo Pagani, Virginie Vitrat, Diamantis Kofteridis, Maria Zacharioudaki, Sofia Maraki, Yulia Weissman, Mical Paul, Yaakov Dickstein, Leonard Leibovici and Dafna Yahav all have nothing to disclose. The study was approved by the local ethical committees of each participating center, which waved informed consent due to the retrospective nature of the study. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request, and with agreement of all contributing authors.

Keywords

Antibiotics
Antimicrobial stewardship
Bacteremia
Duration
Pseudomonas aeruginosa

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s40121-022-00657-1

Cite this

Babich, T., Naucler, P., Valik, J. K., Giske, C. G., Benito, N., Cardona, R., Rivera, A., Pulcini, C., Fattah, M. A., Haquin, J., Macgowan, A., Grier, S., Chazan, B., Yanovskay, A., Ami, R. B., Landes, M., Nesher, L., Zaidman-Shimshovitz, A., McCarthy, K., ... Yahav, D. (2022). Duration of Treatment for Pseudomonas aeruginosa Bacteremia: a Retrospective Study. Infectious Diseases and Therapy, 11(4), 1505-1519. https://doi.org/10.1007/s40121-022-00657-1

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abstract = "Introduction: There is no consensus regarding optimal duration of antibiotic therapy for Pseudomonas aeruginosa bacteremia. We aimed to evaluate the impact of short antibiotic course. Methods: We present a retrospective multicenter study including patients with P. aeruginosa bacteremia during 2009–2015. We evaluated outcomes of patients treated with short (6–10 days) versus long (11–15 days) antibiotic courses. The primary outcome was a composite of 30-day mortality or bacteremia recurrence and/or persistence. Univariate and inverse probability treatment-weighted (IPTW) adjusted multivariate analysis for the primary outcome was performed. To avoid immortal time bias, the landmark method was used. Results: We included 657 patients; 273 received a short antibiotic course and 384 a long course. There was no significant difference in baseline characteristics of patients. The composite primary outcome occurred in 61/384 patients in the long-treatment group (16%) versus 32/273 in the short-treatment group (12%) (p = 0.131). Mortality accounted for 41/384 (11%) versus 25/273 (9%) of cases, respectively. Length of hospital stay was significantly shorter in the short group [median 13 days, interquartile range (IQR) 9–21 days, versus median 15 days, IQR 11–26 days, p = 0.002]. Ten patients in the long group discontinued antibiotic therapy owing to adverse events, compared with none in the short group. On univariate and multivariate analyses, duration of therapy was not associated with the primary outcome. Conclusions: In this retrospective study, 6–10 days of antibiotic course for P. aeruginosa bacteremia were as effective as longer courses in terms of survival and recurrence. Shorter therapy was associated with reduced length of stay and less drug discontinuation.",

keywords = "Antibiotics, Antimicrobial stewardship, Bacteremia, Duration, Pseudomonas aeruginosa",

author = "Tanya Babich and Pontus Naucler and Valik, {John Karlsson} and Giske, {Christian G.} and Natividad Benito and Ruben Cardona and Alba Rivera and Celine Pulcini and Fattah, {Manal Abdel} and Justine Haquin and Alasdair Macgowan and Sally Grier and Bibiana Chazan and Anna Yanovskay and Ami, {Ronen Ben} and Michal Landes and Lior Nesher and Adi Zaidman-Shimshovitz and Kate McCarthy and Paterson, {David L.} and Evelina Tacconelli and Michael Buhl and Susanna Mauer and Jes{\'u}s Rodr{\'i}guez-Ba{\~n}o and {de Cueto}, Marina and Antonio Oliver and {de Gopegui}, {Enrique Ruiz} and Angela Cano and Isabel Machuca and Monica Gozalo-Marguello and Luis Martinez-Martinez and Gonzalez-Barbera, {Eva M.} and Alfaro, {Iris Gomez} and Miguel Salavert and Bojana Beovic and Andreja Saje and Manica Mueller–Premru and Leonardo Pagani and Virginie Vitrat and Diamantis Kofteridis and Maria Zacharioudaki and Sofia Maraki and Yulia Weissman and Mical Paul and Yaakov Dickstein and Leonard Leibovici and Dafna Yahav",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = aug,

doi = "10.1007/s40121-022-00657-1",

language = "אנגלית",

volume = "11",

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journal = "Infectious Diseases and Therapy",

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Babich, T, Naucler, P, Valik, JK, Giske, CG, Benito, N, Cardona, R, Rivera, A, Pulcini, C, Fattah, MA, Haquin, J, Macgowan, A, Grier, S, Chazan, B, Yanovskay, A, Ami, RB, Landes, M, Nesher, L, Zaidman-Shimshovitz, A, McCarthy, K, Paterson, DL, Tacconelli, E, Buhl, M, Mauer, S, Rodríguez-Baño, J, de Cueto, M, Oliver, A, de Gopegui, ER, Cano, A, Machuca, I, Gozalo-Marguello, M, Martinez-Martinez, L, Gonzalez-Barbera, EM, Alfaro, IG, Salavert, M, Beovic, B, Saje, A, Mueller–Premru, M, Pagani, L, Vitrat, V, Kofteridis, D, Zacharioudaki, M, Maraki, S, Weissman, Y, Paul, M, Dickstein, Y, Leibovici, L & Yahav, D 2022, 'Duration of Treatment for Pseudomonas aeruginosa Bacteremia: a Retrospective Study', Infectious Diseases and Therapy, vol. 11, no. 4, pp. 1505-1519. https://doi.org/10.1007/s40121-022-00657-1

TY - JOUR

T1 - Duration of Treatment for Pseudomonas aeruginosa Bacteremia

T2 - a Retrospective Study

AU - Babich, Tanya

AU - Naucler, Pontus

AU - Valik, John Karlsson

AU - Giske, Christian G.

AU - Benito, Natividad

AU - Cardona, Ruben

AU - Rivera, Alba

AU - Pulcini, Celine

AU - Fattah, Manal Abdel

AU - Haquin, Justine

AU - Macgowan, Alasdair

AU - Grier, Sally

AU - Chazan, Bibiana

AU - Yanovskay, Anna

AU - Ami, Ronen Ben

AU - Landes, Michal

AU - Nesher, Lior

AU - Zaidman-Shimshovitz, Adi

AU - McCarthy, Kate

AU - Paterson, David L.

AU - Tacconelli, Evelina

AU - Buhl, Michael

AU - Mauer, Susanna

AU - Rodríguez-Baño, Jesús

AU - de Cueto, Marina

AU - Oliver, Antonio

AU - de Gopegui, Enrique Ruiz

AU - Cano, Angela

AU - Machuca, Isabel

AU - Gozalo-Marguello, Monica

AU - Martinez-Martinez, Luis

AU - Gonzalez-Barbera, Eva M.

AU - Alfaro, Iris Gomez

AU - Salavert, Miguel

AU - Beovic, Bojana

AU - Saje, Andreja

AU - Mueller–Premru, Manica

AU - Pagani, Leonardo

AU - Vitrat, Virginie

AU - Kofteridis, Diamantis

AU - Zacharioudaki, Maria

AU - Maraki, Sofia

AU - Weissman, Yulia

AU - Paul, Mical

AU - Dickstein, Yaakov

AU - Leibovici, Leonard

AU - Yahav, Dafna

PY - 2022/8

Y1 - 2022/8

N2 - Introduction: There is no consensus regarding optimal duration of antibiotic therapy for Pseudomonas aeruginosa bacteremia. We aimed to evaluate the impact of short antibiotic course. Methods: We present a retrospective multicenter study including patients with P. aeruginosa bacteremia during 2009–2015. We evaluated outcomes of patients treated with short (6–10 days) versus long (11–15 days) antibiotic courses. The primary outcome was a composite of 30-day mortality or bacteremia recurrence and/or persistence. Univariate and inverse probability treatment-weighted (IPTW) adjusted multivariate analysis for the primary outcome was performed. To avoid immortal time bias, the landmark method was used. Results: We included 657 patients; 273 received a short antibiotic course and 384 a long course. There was no significant difference in baseline characteristics of patients. The composite primary outcome occurred in 61/384 patients in the long-treatment group (16%) versus 32/273 in the short-treatment group (12%) (p = 0.131). Mortality accounted for 41/384 (11%) versus 25/273 (9%) of cases, respectively. Length of hospital stay was significantly shorter in the short group [median 13 days, interquartile range (IQR) 9–21 days, versus median 15 days, IQR 11–26 days, p = 0.002]. Ten patients in the long group discontinued antibiotic therapy owing to adverse events, compared with none in the short group. On univariate and multivariate analyses, duration of therapy was not associated with the primary outcome. Conclusions: In this retrospective study, 6–10 days of antibiotic course for P. aeruginosa bacteremia were as effective as longer courses in terms of survival and recurrence. Shorter therapy was associated with reduced length of stay and less drug discontinuation.

AB - Introduction: There is no consensus regarding optimal duration of antibiotic therapy for Pseudomonas aeruginosa bacteremia. We aimed to evaluate the impact of short antibiotic course. Methods: We present a retrospective multicenter study including patients with P. aeruginosa bacteremia during 2009–2015. We evaluated outcomes of patients treated with short (6–10 days) versus long (11–15 days) antibiotic courses. The primary outcome was a composite of 30-day mortality or bacteremia recurrence and/or persistence. Univariate and inverse probability treatment-weighted (IPTW) adjusted multivariate analysis for the primary outcome was performed. To avoid immortal time bias, the landmark method was used. Results: We included 657 patients; 273 received a short antibiotic course and 384 a long course. There was no significant difference in baseline characteristics of patients. The composite primary outcome occurred in 61/384 patients in the long-treatment group (16%) versus 32/273 in the short-treatment group (12%) (p = 0.131). Mortality accounted for 41/384 (11%) versus 25/273 (9%) of cases, respectively. Length of hospital stay was significantly shorter in the short group [median 13 days, interquartile range (IQR) 9–21 days, versus median 15 days, IQR 11–26 days, p = 0.002]. Ten patients in the long group discontinued antibiotic therapy owing to adverse events, compared with none in the short group. On univariate and multivariate analyses, duration of therapy was not associated with the primary outcome. Conclusions: In this retrospective study, 6–10 days of antibiotic course for P. aeruginosa bacteremia were as effective as longer courses in terms of survival and recurrence. Shorter therapy was associated with reduced length of stay and less drug discontinuation.

KW - Antibiotics

KW - Antimicrobial stewardship

KW - Bacteremia

KW - Duration

KW - Pseudomonas aeruginosa

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SN - 2193-8229

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JF - Infectious Diseases and Therapy

IS - 4

ER -

Duration of Treatment for Pseudomonas aeruginosa Bacteremia: a Retrospective Study

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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