Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 Sep;43(9):1741-1751.
doi: 10.1007/s10096-024-04885-w. Epub 2024 Jul 3.

Seven-day antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients: toward a new paradigm

Fabián Herrera  1 , Diego Torres  2 , Ana Laborde  3 , Rosana Jordán  4 , Lucas Tula  5 , Noelia Mañez  6 , María Laura Pereyra  7 , Nadia Suchowiercha  8 , Lorena Berruezo  9 , Carlota Gudiol  10 , María Luz González Ibáñez  3 , María José Eusebio  4 , Sandra Lambert  5 , Laura Barcán  6 , Inés Roccia Rossi  8 , Federico Nicola  11 , Magdalena Pennini  12 , Renata Monge  13 , Miriam Blanco  14 , Mariángeles Visús  15 , Mariana Reynaldi  16 , Ruth Carbone  17 , Fernando Pasterán  18 , Alejandra Corso  18 , Melina Rapoport  18 , Alberto Angel Carena  2 ; Argentine Group for the Study of Bacteremia in Cancer, Stem Cell Transplant (ROCAS) Study
Collaborators, Affiliations
Observational Study

Seven-day antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients: toward a new paradigm

Fabián Herrera et al. Eur J Clin Microbiol Infect Dis. 2024 Sep.

Abstract

Purpose: Data on short courses of antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients are limited. The aim of the study was to describe and compare the frequency of bacteremia relapse, 30-day overall and infection-related mortality, Clostridiodes difficile infection and length of hospital stay since bacteremia among those who received antibiotic therapy for 7 or 14 days.

Methods: This is a multicenter, prospective, observational cohort study in adult high-risk neutropenic patients with hematologic malignancies or hematopoietic stem cell transplant and monomicrobial Enterobacterales bacteremia. They received appropriate empirical antibiotic therapy, had a clinical response within 7 days, and infection source control. Clinical, epidemiological and outcomes variables were compared based on 7 or 14 days of AT.

Results: Two hundred patients were included (100, 7-day antibiotic therapy; 100, 14-day antibiotic therapy). Escherichia coli was the pathogen most frequently isolated (47.5%), followed by Klebsiella sp. (40.5%). Among those patients that received 7-day vs. 14-day antibiotic course, a clinical source of bacteremia was found in 54% vs. 57% (p = 0.66), multidrug-resistant Enterobacterales isolates in 28% vs. 30% (p = 0.75), and 40% vs. 47% (p = 0.31) received combined empirical antibiotic therapy. Overall mortality was 3% vs. 1% (p = 0.62), in no case related to infection; bacteremia relapse was 7% vs. 2% (p = 0.17), and length of hospital stay since bacteremia had a median of 9 days (IQR: 7-15) vs. 14 days (IQR: 13-22) (p = < 0.001).

Conclusions: These data suggest that seven-day antibiotic therapy might be adequate for patients with high-risk neutropenia and Enterobacterales bacteremia, who receive appropriate empirical therapy, with clinical response and infection source control.

Keywords: Antibiotic; Bacteremia; Neutropenia; Seven-day.

PubMed Disclaimer

References

    1. Kuderer NM, Dale DC, Crawford J, Cosler LE, Lyman GH (2006) Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer 106(10):2258–2266. https://doi.org/10.1002/cncr.21847 - DOI - PubMed
    1. Bos MM, Smeets LS, Dumay I, de Jonge E (2013) Bloodstream infections in patients with or without cancer in a large community hospital. Infection 41(5):949–958. https://doi.org/10.1007/s15010-013-0468-1 - DOI - PubMed
    1. Dandoy CE, Ardura MI, Papanicolaou GA, Auletta JJ (2017) Bacterial bloodstream infections in the allogeneic hematopoietic cell transplant patient: new considerations for a persistent nemesis. Bone Marrow Transplant 52(8):1091–1106. https://doi.org/10.1038/bmt.2017.14 - DOI - PubMed
    1. Trecarichi EM, Pagano L, Candoni A, Pastore D, Cattaneo C, Fanci R, Nosari A, Caira M, Spadea A, Busca A, Vianelli N, Tumbarello M, HeMABISRegistry—SEIFEM Group, Italy (2015) Current epidemiology and antimicrobial resistance data for bacterial bloodstream infections in patients with hematologic malignancies: an Italian multicentre prospective survey. Clin Microbiol Infect. 21(4):337–43. https://doi.org/10.1016/j.cmi.2014.11.022 - DOI - PubMed
    1. Averbuch D, Tridello G, Hoek J et al (2017) Antimicrobial resistance in gram-negative rods causing bacteremia in hematopoietic stem cell transplant recipients: intercontinental prospective study of the infectious diseases working party of the european bone marrow transplantation group. Clin Infect Dis 65(11):1819–1828. https://doi.org/10.1093/cid/cix646 - DOI - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources