Duration of antibiotic therapy in systemic lupus erythematosus patients with hospital-acquired bacterial pneumonia in eastern China

Abstract

Background: To investigate the duration of antibiotic therapy and its influencing factors in treating systemic lupus erythematosus (SLE) patients with hospital-acquired bacterial pneumonia (HABP).

Methods: Clinical data of SLE patients with HABP from January 2015 to December 2019 were collected. Duration of antibiotic treatment and its correlations with the severity of pneumonia, status of SLE and the time to clinical stability (TCS) were analysed. A logistic regression model was performed to screen the risk factors influencing the total antibiotic treatment course >7 days.

Results: Three hundred and forty-four patients were finally enrolled in the study and the mean duration of total antibiotic therapy was 9.5 days. The TCS was related to the duration of antibiotic therapy (R2 =0.76, P<0.0001). More patients with multidrug-resistant pathogen infection and Candida colonization were found in the total duration >7 days group. SLE disease activity index (SLEDAI) [odds ratio (OR) =5.52, 95% confidence interval (CI): 3.59-7.28], taking immunosuppressants during HABP treatment (OR =5.29, 95% CI: 3.93-7.09) and multidrug-resistant pathogen infection (OR =4.91, 95% CI: 1.45-6.87) were greatly impacted risk factors (P<0.05, respectively).

Conclusions: The duration of antibiotic therapy in SLE patients with HABP was longer than the course recommended by practice guidelines. The severity of the disease and the host's immune status might influence the duration of treatment.

Keywords: Hospital-acquired bacterial pneumonia (HABP); antibiotics; immunocompromised host (ICH); systemic lupus erythematosus (SLE).