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• W2332592647 abstract "Introduction: The optimal duration of therapy for Gram-negative bacteremia (GNB) has not been well described in the literature. Currently, the only guideline recommendation regarding duration of treatment for bacteremia is for catheter-related bloodstream infections (CRBSI), which recommends 7-14 days of therapy. Several CRBSI studies exist using a wide variety of treatment durations. However, there are few high quality data that suggest a short course (7 days) is effective for GNB. Hypothesis: Short duration therapy (?7days) for GNB in critically ill trauma patients results in an acceptable clinical and microbiologic success rate. Methods: Retrospective analysis was performed on all patients with a GNB admitted to the Presley Regional Trauma Center in Memphis, TN from January 2008 through December 2010. GNB was defined as growth of a Gram-negative pathogen in?1 bottle(s) from blood cultures. Patients were excluded if they received fewer than 48 hours of antibiotics or were immunocompromised. Included patients were categorized as having short duration (?7 day) or long duration therapy (>7 days). Treatment duration was at the discretion of the trauma ICU team. Clinical and microbiologic success and failure were graded using standard definitions. Results: Over the 3 year period, 129 patients were identified and then 9 were excluded. Mean age was 44 ± 18 years, Injury Severity Score 33 (IQR 22 – 41), 77% male, with 87% blunt injuries. After exclusions, 120 patients were analyzed (72 short group; 48 long group). Patients in the long group were significantly more likely to have abdominal trauma at baseline (45% vs. 25%, p=0.03), be treated with multiple antibiotics (p = 0.003), have lungs as the identified source of bacteremia (0.02), and have a concurrent bacteremia with a Gram-positive organism (p = 0.04). Clinical success was 72/78 (92%) vs. 48/51 patients (94%) in the short and long groups respectively (p = NS). For patients with follow-up cultures, microbiologic success was 34/36 (94%) vs. 27/33 (82%) in the short and long groups respectively (p = NS). Conclusions: Short duration of treatment for GNB (7 days) results in acceptable clinical and microbiologic success rates in critically ill trauma patients." @default.
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• W2332592647 date "2012-12-01" @default.
• W2332592647 modified "2023-10-16" @default.
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• W2332592647 doi "https://doi.org/10.1097/01.ccm.0000424567.34469.35" @default.
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