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INTRODUCTION: Hospital-acquired bloodstream infections (HA-BSIs) are severe and require antibiotic therapy. In non-complicated BSIs, shortened therapy reduces side effects without compromising efficacy. The impact of shortened antibiotic therapy in HA-BSI critically ill patients without indication of prolonged therapy requires further evaluation. METHODS: Using the international prospective EUROBACT-2 cohort, we compared shortened (7-10 days) versus long (14-21 days) treatment durations in ICU patients eligible for shortened therapy. Patients without antibiotic therapy within 3 days after HA-BSI occurrence or requiring prolonged therapy (due to infection source, microorganism, or clinical deterioration) were excluded. Treatment failure, defined as death, persistent infection, or subsequent infectious complications by Day 28, was assessed using an inverse-probability of treatment weighted (IPTW) logistic regression. RESULTS: Among 2600 patients, 550 were eligible for shortened treatment, 213 received short, and 337 received long treatment. The most common infection source was intravascular catheters (33%), most common microorganisms were Enterobacterales (39%). Patients with long treatment were more frequently infected with Staphylococcus aureus (11% vs. 5.6%, p = 0.025) or difficult-to-treat microorganisms (23% vs. 7%, p < 0.001), and received more commonly combination therapy (46% vs. 30%, p < 0.001). Short treatment was associated with reduced 28-day treatment failure (OR 0.64, 95% CI 0.44-0.93, p = 0.019), mainly due to reduction in subsequent infectious complications (OR 0.58, 95% CI 0.37-0.91, p = 0.018). Mortality (OR 0.92 [95% CI 0.59, 1.43], p = 0.7) and persistent infection rates (OR 0.47 [95% CI 0.17, 1.14], p = 0.12) were similar. CONCLUSIONS: In selected ICU patients with HA-BSI, shortened antibiotic treatment might be considered. Eurobact2 was a prospective international cohort study, registered in ClinicalTrials.org (NCT03937245).
| Idioma original | Inglés |
|---|---|
| Número de artículo | N/A |
| Páginas (desde-hasta) | 518-528 |
| Número de páginas | 11 |
| Publicación | Intensive Care Medicine |
| Volumen | 51 |
| N.º | 3 |
| DOI | |
| Estado | Publicada - 7 abr. 2025 |
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Profundice en los temas de investigación de 'Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database'. En conjunto forman una huella única.Proyectos
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Epidemiology And Determinants Of Outcomes Of Hospital Acquired Blood Stream Infections In The Intensive Care (Eurobact)
Reyes Velasco, L. F. (Investigador principal) & Lozada Arciniegas, J. A. (Investigador)
1/07/20 → 1/07/22
Proyecto: Proyectos de Investigación
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Gajdos, L., Buetti, N., Tabah, A., Ruckly, S., Akova, M., Sjöval, F., Arvanti, K., De Waele, J., Bracht, H., Barbier, F., Timsit, J.-F., Tabah, A., Lipman, J., Tabah, A., Pollock, H., Margetts, B., Udy, A., Young, M., Bhadange, N., ... Hamid, H. K. S. (2025). Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database. Intensive Care Medicine, 51(3), 518-528. Artículo N/A. https://doi.org/10.1007/s00134-025-07857-6
Gajdos, Lena ; Buetti, Niccolo ; Tabah, Alexis et al. / Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database. En: Intensive Care Medicine. 2025 ; Vol. 51, N.º 3. pp. 518-528.
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title = "Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database",
abstract = "INTRODUCTION: Hospital-acquired bloodstream infections (HA-BSIs) are severe and require antibiotic therapy. In non-complicated BSIs, shortened therapy reduces side effects without compromising efficacy. The impact of shortened antibiotic therapy in HA-BSI critically ill patients without indication of prolonged therapy requires further evaluation. METHODS: Using the international prospective EUROBACT-2 cohort, we compared shortened (7-10 days) versus long (14-21 days) treatment durations in ICU patients eligible for shortened therapy. Patients without antibiotic therapy within 3 days after HA-BSI occurrence or requiring prolonged therapy (due to infection source, microorganism, or clinical deterioration) were excluded. Treatment failure, defined as death, persistent infection, or subsequent infectious complications by Day 28, was assessed using an inverse-probability of treatment weighted (IPTW) logistic regression. RESULTS: Among 2600 patients, 550 were eligible for shortened treatment, 213 received short, and 337 received long treatment. The most common infection source was intravascular catheters (33\%), most common microorganisms were Enterobacterales (39\%). Patients with long treatment were more frequently infected with Staphylococcus aureus (11\% vs. 5.6\%, p = 0.025) or difficult-to-treat microorganisms (23\% vs. 7\%, p < 0.001), and received more commonly combination therapy (46\% vs. 30\%, p < 0.001). Short treatment was associated with reduced 28-day treatment failure (OR 0.64, 95\% CI 0.44-0.93, p = 0.019), mainly due to reduction in subsequent infectious complications (OR 0.58, 95\% CI 0.37-0.91, p = 0.018). Mortality (OR 0.92 [95\% CI 0.59, 1.43], p = 0.7) and persistent infection rates (OR 0.47 [95\% CI 0.17, 1.14], p = 0.12) were similar. CONCLUSIONS: In selected ICU patients with HA-BSI, shortened antibiotic treatment might be considered. Eurobact2 was a prospective international cohort study, registered in ClinicalTrials.org (NCT03937245).",
author = "Lena Gajdos and Niccolo Buetti and Alexis Tabah and Stephane Ruckly and Murat Akova and Frederik Sj{\"o}val and Kostoula Arvanti and \{De Waele\}, Jan and Hendrik Bracht and Francois Barbier and Jean-Fran{\c c}ois Timsit and Alexis Tabah and Jeffrey Lipman and Alexis Tabah and Hamish Pollock and Ben Margetts and Andrew Udy and Meredith Young and Neeraj Bhadange and Steven Tyler and Anne Ledtischke and Mackenzie Finnis and Anne Ledtischke and Mackenzie Finnis and Jyotsna Dwivedi and Manoj Saxena and Vishwanath Biradar and Natalie Soar and Vineet Sarode and David Brewster and Adrian Regli and Elizabeth Weeda and Samiul Ahmed and Cheryl Fourie and Kevin Laupland and Mahesh Ramanan and James Walsham and Jason Meyer and Edward Litton and Palermo, \{Anna Maria\} and Timothy Yap and Ege Eroglu and Attokaran, \{Antony George\} and C{\textquoteright}havala Jaramillo and Nafees, \{Khalid Mk\} and Nafees, \{Khalid Mahmood Khan\} and Rashid, \{Nurhikmahtul Aqilah Haji Abd\} and Walid, \{Haji Adi Muhamad Ibnu\} and Tomas Mon and Moorthi, \{P. 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Shahnaz\} and Jamaluddin, \{Muhamad Fadhil Hadi\} and Pheng, \{Lee See\} and Sheshendrasurian Visvalingam and Liew, \{Mun Thing\} and Wong, \{Siong Ling Danny\} and Fong, \{Kean Khang\} and Rahman, \{Hamizah Bt Abdul\} and Noor, \{Zuraini Md\} and Tong, \{Lee Kok\} and Azman, \{Abd. Hamid\} and Mazlan, \{Mohd Zulfakar\} and Saedah Ali and Hernandez, \{Aaron Mark\} and Anton Abello and Kyeongman Jeon and Kyeongman Jeon and Sang-Min Lee and Sunghoon Park and Park, \{Seung Yong\} and Lim, \{Sung Yoon\} and Kwa, \{Andrea Lay Hoon\} and Goh, \{Qing Yuan\} and Goh, \{Qing Yuan\} and Ng, \{Shin Yi\} and Lie, \{Sui An\} and Kwa, \{Andrea Lay Hoon\} and Goh, \{Ken Junyang\} and Li, \{Andrew Yunkai\} and Ong, \{Caroline Yu Ming\} and Lim, \{Jia Yan\} and Quah, \{Jessica Lishan\} and Kangqi Ng and Yeh, \{Tony Yu-Chang\} and Yeh, \{Yu Chang\} and Nai-Kuan Chou and Cong-Tat Cia and Ting-Yu Hu and Li-Kuo Kuo and Shih-Chi Ku and Phunsup Wongsurakiat and Phunsup Wongsurakiat and Yutthana Apichatbutr and Supattra Chiewroongro and Adel Alsisi and Rashid Nadeem and Houfi, \{Ashraf El\} and Adel Alsisi and Adel Alsisi and Amr Elhadidy and Mina Barsoum and Nermin Osman and Tarek Mostafa and Mohamed Elbahnasawy and Ahmed Saber and Amer Aldhalia and Omar Elmandouh and Ahmed Elsayed and Elbadawy, \{Merihan A.\} and Awad, \{Ahmed K.\} and Hemead, \{Hanan M.\} and Farid Zand and Farid Zand and Maryam Ouhadian and Borsi, \{Seyed Hamid\} and Zahra Mehraban and Davood Kashipazha and Fatemeh Ahmadi and Mohsen Savaie and Farhad Soltani and Mahboobeh Rashidi and Reza Baghbanian and Fatemeh Javaherforoosh and Fereshteh Amiri and Arash Kiani and Zargar, \{Mohammad Amin\} and Ata Mahmoodpoor and Fatemeh Aalinezhad and Gholamreza Dabiri and Golnar Sabetian and Hakimeh Sarshad and Mansoor Masjedi and Ramin Tajvidi and Tabatabaei, \{Seyed Mohammad Nasirodin\} and Ahmed, \{Abdullah Khudhur\} and Pierre Singer and Pierre Singer and Ilya Kagan and Merav Rigler and Daniel Belman and Phillip Levin and Belal Harara and Adei Diab and Fayez Abillama and Fayez Abilama and Rebecca Ibrahim and Aya Fares and Muhammed Elhadi and Ahmad Buimsaedah and Marwa Gamra and Ahmed Aqeelah and AliAli, \{Almajdoub Mohammed\} and Homaidan, \{Ahmed Gaber Sadik\} and Bushray Almiqlash and Hala Bilkhayr and Ahmad Bouhuwaish and Taher, \{Ahmed Sa\} and Eman Abdulwahed and Abousnina, \{Fathi A.\} and Hdada, \{Aisha Khaled\} and Rania Jobran and Hasan, \{Hayat Ben\} and Hasan, \{Rabab Shaban Ben\} and Khalid Abidi and Issam Serghini and Rachid Seddiki and Brahim Boukatta and Nabil Kanjaa and Doumiri Mouhssine and Wajdi, \{Maazouzi Ahmed\} and Tarek Dendane and Zeggwagh, \{Amine Ali\} and Brahim Housni and Oujidi Younes and Abdelhamid Hachimi and A. 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Ignacio\} and Mariana Novo and Blasco-Navalpotro, \{Miguel Angel\} and Gallego, \{Alberto Orejas\} and Fredrik Sjovall and Fredrik Sj{\"o}vall and Dzana Spahic and Svensson, \{Carl Johan\} and Michael Haney and Alicia Edin and Joyce {\AA}kerlund and \{De Geer\}, Lina and Josef Prazak and Niccol{\`o} Buetti and Josef Prazak and Stephan Jakob and Pagani, \{J. L.\} and S. Abed-Maillard and Murat Akova and Aslan, \{Abdullah Tarık\} and Murat Akova and Aslan, \{Abdullah Tarik\} and Arif Timuroglu and Sesin Kocagoz and Hulya Kusoglu and Selcuk Mehtap and Solakoğlu Ceyhun and Altintas, \{Neriman Defne\} and Leyla Talan and Bircan Kayaaslan and Kalem, \{Ay{\c s}e Kaya\} and Ibrahim Kurt and Murat Telli and Barcin Ozturk and {\c C}iğdem Erol and Demiray, \{Emine Kubra Dindar\} and Sait {\c C}olak and T{\"u}rkay Akbas and Kursat Gundogan and Ali Sari and Canan Agalar and Onur {\c C}olak and Nurcan Baykam and Ozlem Akdogan and Mesut Yilmaz and Burcu Tunay and Rumeysa Cakmak and Nese Saltoglu and Ridvan Karaali and Iftihar Koksal and Firdevs Aksoy and Ahmet Eroglu and Saracoglu, \{Kemal Tolga\} and Yeliz Bilir and Gulden Ersoz and Guliz Evik and Hulya Sungurtekin and Cansu Ozgen and Cem Erdoğan and Yunus G{\"u}rb{\"u}z and Nilg{\"u}n Altin and Yasar Bayindir and Yasemin Ersoy and Senay Goksu and Ayse Batirel and Aktas, \{Sabahat Cagan\} and Morris, \{Andrew Conway\} and Morris, \{Andrew Conway\} and Matthew Routledge and Morris, \{Andrew Conway\} and Ari Ercole and David Antcliffe and Roceld Rojo and Kate Tizard and Maria Faulkner and Amanda Cowton and Melanie Kent and Ashok Raj and Artemis Zormpa and George Tinaslanidis and Reena Khade and Tomasz Torlinski and Randeep Mulhi and Shraddha Goyal and Manan Bajaj and Marina Soltan and Aimee Yonan and Rachael Dolan and Aimee Johnson and Caroline Macfie and James Lennard and Maie Templeton and Arias, \{Sonia Sousa\} and Uwe Franke and Keith Hugill and Hollie Angell and Parcell, \{Benjamin J.\} and Katherine Cobb and Stephen Cole and Tim Smith and Clive Graham and Jaroslav Cerman and Allison Keegan and Jenny Ritzema and Amanda Sanderson and Ashraf Roshdy and Tamas Szakmany and Tom Baumer and Rebecca Longbottom and Daniel Hall and Kate Tatham and S. Loftus and A. Husain and E. Black and S. Jhanji and RRao Baikady and Peter Mcguigan and Rachel Mckee and Santhana Kannan and Supriya Antrolikar and Nicholas Marsden and Torre, \{Valentina Della\} and Dorota Banach and Ahmed Zaki and Matthew Jackson and Moses Chikungwa and Ben Attwood and Jamie Patel and Tilley, \{Rebecca E.\} and Humphreys, \{Sally K.\} and Renaud, \{Paul Jean\} and Anton Sokhan and Yaroslava Burma and Wendy Sligl and Wendy Sligl and Kutsogiannis, \{Demetrios J.\} and Wendy Sligl and Raihan Rabbani and Raihan Rabbani and Huq, \{Shihan Mahmud Redwanul\} and Rajib Hasan and Islam, \{Mohammad Motiul\} and Mohan Gurjar and Mohan Gurjar and Arvind Baronia and Nikhil Kothari and Ankur Sharma and Saurabh Karmakar and Priya Sharma and Janardan Nimbolkar and Pratit Samdani and R. Vaidyanathan and Rubina, \{Noor Ahmedi\} and Nikhilesh Jain and Madhumati Pahuja and Ritu Singh and Saurav Shekhar and Muzaffar, \{Syed Nabeel\} and Ahmad Ozair and Siddiqui, \{Suhail Sarwar\} and Payel Bose and Avijatri Datta and Darshana Rathod and Mayur Patel and Renuka, \{M. K.\} and Baby, \{Sailaja K.\} and Carol Dsilva and Jagadish Chandran and Pralay Ghosh and Sudipta Mukherjee and Kaladhar Sheshala and Misra, \{Krushna Chandra\} and Adekola, \{Oyebola O.\} and Yakubu, \{Saidu Yusuf\} and Ugwu, \{Euphemia Mgbosoro\} and John Olatosi and Ibironke Desalu and Gabriel Asiyanbi and Motunrayo Oladimeji and Olusola Idowu and Fowotade Adeola and Mervyn Mer and Mervyn Mer and \{Mc Cree\}, Melanie and Sanousi, \{Bashir El\} and Karar, \{Ali Adil Ali\} and Elfayadh Saidahmed and Hamid, \{Hytham K. S.\}",
note = "Publisher Copyright: {\textcopyright} 2025. Springer-Verlag GmbH Germany, part of Springer Nature.",
year = "2025",
month = apr,
day = "7",
doi = "10.1007/s00134-025-07857-6",
language = "Ingl{\'e}s",
volume = "51",
pages = "518--528",
journal = "Intensive Care Medicine",
issn = "0342-4642",
publisher = "Springer Science and Business Media Deutschland GmbH",
number = "3",
}
Gajdos, L, Buetti, N, Tabah, A, Ruckly, S, Akova, M, Sjöval, F, Arvanti, K, De Waele, J, Bracht, H, Barbier, F, Timsit, J-F, Tabah, A, Lipman, J, Tabah, A, Pollock, H, Margetts, B, Udy, A, Young, M, Bhadange, N, Tyler, S, Ledtischke, A, Finnis, M, Ledtischke, A, Finnis, M, Dwivedi, J, Saxena, M, Biradar, V, Soar, N, Sarode, V, Brewster, D, Regli, A, Weeda, E, Ahmed, S, Fourie, C, Laupland, K, Ramanan, M, Walsham, J, Meyer, J, Litton, E, Palermo, AM, Yap, T, Eroglu, E, Attokaran, AG, Jaramillo, C, Nafees, KM, Nafees, KMK, Rashid, NAHA, Walid, HAMI, Mon, T, Moorthi, PD, Sudhirchandra, S, Sridharan, DD, Haibo, Q, Xie, J, Haibo, Q, Jianfeng, X, Wei-Hua, L, Zhen, W, Qian, C, Luo, J, Chen, X, Wang, H, Zhao, P, Zhao, J, Wusi, Q, Mingmin, C, Xu, L, Yin, C, Wang, R, Wang, J, Yin, Y, Zhang, M, Ye, J, Hu, C, Zhou, S, Huang, M, Yan, J, Wang, Y, Qin, B, Ye, L, Weifeng, X, Peije, L, Geng, N, Ling, L, Ling, L, Hayashi, Y, Hayashi, Y, Karumai, T, Yamasaki, M, Hashimoto, S, Hosokawa, K, Makino, J, 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Reyes, LF, Ñamendys-Silva, SA, Ñamendys-Silva, SA, Romero-Gonzalez, JP, Hermosillo, M, Castillo, RA, Leal, JNP, Aguilar, CG, Herrera, MOG, Villafuerte, MVE, Lomeli-Teran, M, Dominguez-Cherit, JG, Ñamendys-Silva, AD-AA, Sánchez-Hurtado, L, Tejeda-Huezo, B, Tomas, ORP-NED, De Bus, L, De Waele, J, De Bus, GF, De Waele, J, Hollevoet, I, Denys, W, Bourgeois, M, Vanderhaeghen, SFM, Mesland, J-B, Henin, P, Haentjens, L, Noel, PBC, Misset, NLB, De Schryver Nicolas Serck, N, De Waele, XWE, Opdenacker, G, Kovacevic, P, Kovacevic, P, Zlojutro, B, Filipovic-Grcic, I, Custovic, A, Filipovic-Grcic, I, Radonic, R, Brajkovic, AV, Persec, J, Sakan, S, Nikolic, M, Lasic, H, Leone, M, Timsit, J-F, Ruppe, E, Ruckly, S, Montravers, P, Leone, M, Arbelot, C, Zappella, J-FTN, Montravers, P, Dulac, T, Castanera, J, Le Meur, JAA, Marchalot, A, Beuzelin, M, Guesdon, AMC, Escudier, E, Rosman, PMJ, Alfandari, OLS, Nica, A, Coupez, BSE, Kipnis, TDE, Bortolotti, P, Le Souhaitier, M, Mira, J-P, Duprey, PGM, Paulet, MTR, Tran, FPM, Bruel, C, Weiss, E, Janny, S, Foucrier, A, Perrigault, P-F, Djanikian, F, Barbier, F, Bourenne, MGJ, Louis, G, Smonig, R, Baudry, LAT, Razazi, AMDK, Badre, PKG, Larcher, R, Lefrant, J-Y, Roger, C, Silva, BSS, Le Guennec, SDL, Siami, S, Aparicio, C, Voiriot, G, Fartoukh, M, Dahyot-Fizelier, C, Imzi, N, Klouche, K, Bracht, H, Bracht, H, Hoheisen, S, Bloos, F, Thomas-Rueddel, D, Petros, S, Pasieka, B, Schmidt, SDK, Gottschalk, A, Wempe, C, Lepper, P, Metz, C, Viderman, D, Viderman, D, Umbetzhanov, Y, Mugazov, M, Bazhykayeva, Y, Kaligozhin, Z, Babashev, B, Merenkov, Y, Temirov, T, Arvaniti, K, Arvaniti, K, Smyrniotis, D, Psallida, V, Fildisis, G, Soulountsi, V, Kaimakamis, E, Iasonidou, C, Papoti, S, Renta, F, Vasileiou, M, Romanou, V, Koutsoukou, V, Matei, MK, Moldovan, L, Karaiskos, I, Paskalis, H, Marmanidou, K, Papanikolaou, M, Kampolis, C, Oikonomou, M, Kogkopoulos, E, Nikolaou, C, Sakkalis, A, Georgopoulou, MCM, Chantziara, AEV, Athanasa, ASZ, Papageorgiou, E, Ali, F, 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Medicine, vol. 51, n.º 3, N/A, pp. 518-528. https://doi.org/10.1007/s00134-025-07857-6
Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database. / Gajdos, Lena (Primer Autor); Buetti, Niccolo (Segundo Autor); Tabah, Alexis (Tercer Autor) et al.
En: Intensive Care Medicine, Vol. 51, N.º 3, N/A, 07.04.2025, p. 518-528.
En: Intensive Care Medicine, Vol. 51, N.º 3, N/A, 07.04.2025, p. 518-528.
Producción científica: Contribución a una revista › Artículo › revisión exhaustiva
TY - JOUR
T1 - Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database
AU - Gajdos, Lena
AU - Buetti, Niccolo
AU - Tabah, Alexis
AU - Sjöval, Frederik
AU - Arvanti, Kostoula
AU - De Waele, Jan
AU - Bracht, Hendrik
AU - Barbier, Francois
AU - Timsit, Jean-François
AU - Tabah, Alexis
AU - Lipman, Jeffrey
AU - Tabah, Alexis
AU - Pollock, Hamish
AU - Margetts, Ben
AU - Udy, Andrew
AU - Young, Meredith
AU - Bhadange, Neeraj
AU - Tyler, Steven
AU - Ledtischke, Anne
AU - Finnis, Mackenzie
AU - Ledtischke, Anne
AU - Finnis, Mackenzie
AU - Dwivedi, Jyotsna
AU - Saxena, Manoj
AU - Biradar, Vishwanath
AU - Soar, Natalie
AU - Sarode, Vineet
AU - Brewster, David
AU - Regli, Adrian
AU - Weeda, Elizabeth
AU - Ahmed, Samiul
AU - Fourie, Cheryl
AU - Laupland, Kevin
AU - Ramanan, Mahesh
AU - Walsham, James
AU - Meyer, Jason
AU - Litton, Edward
AU - Palermo, Anna Maria
AU - Yap, Timothy
AU - Eroglu, Ege
AU - Attokaran, Antony George
AU - Jaramillo, C’havala
AU - Nafees, Khalid Mk
AU - Nafees, Khalid Mahmood Khan
AU - Rashid, Nurhikmahtul Aqilah Haji Abd
AU - Walid, Haji Adi Muhamad Ibnu
AU - Mon, Tomas
AU - Moorthi, P. Dhakshina
AU - Sudhirchandra, Shah
AU - Sridharan, Dhadappa Damodar
AU - Haibo, Qiu
AU - Xie, Jianfeng
AU - Haibo, Qiu
AU - Jianfeng, Xie
AU - Wei-Hua, Lu
AU - Zhen, Wang
AU - Qian, Chuanyun
AU - Luo, Jili
AU - Chen, Xiaomei
AU - Wang, Hao
AU - Zhao, Peng
AU - Zhao, Juan
AU - Wusi, Qiu
AU - Mingmin, Chen
AU - Xu, Lei
AU - Yin, Chengfen
AU - Wang, Ruilan
AU - Wang, Jinfeng
AU - Yin, Yongjie
AU - Zhang, Min
AU - Ye, Jilu
AU - Hu, Chungfang
AU - Zhou, Suming
AU - Huang, Min
AU - Yan, Jing
AU - Wang, Yan
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AU - Ye, Ling
AU - Weifeng, Xie
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AU - Geng, Nan
AU - Ling, Lowell
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AU - Hayashi, Yoshiro
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AU - Karumai, Toshiyuki
AU - Yamasaki, Masaki
AU - Hashimoto, Satoru
AU - Hosokawa, Koji
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AU - Matsuyoshi, Takeo
AU - Kuriyama, Akira
AU - Shigemitsu, Hidenobu
AU - Mishima, Yuka
AU - Nagashima, Michio
AU - Yoshida, Hideki
AU - Fujitani, Shigeki
AU - Omori, Koichiro
AU - Rinka, Hiroshi
AU - Saito, Hiroki
AU - Atobe, Kaori
AU - Kato, Hideaki
AU - Takaki, Shunsuke
AU - Sulaiman, Helmi
AU - Hasan, M. Shahnaz
AU - Jamaluddin, Muhamad Fadhil Hadi
AU - Pheng, Lee See
AU - Visvalingam, Sheshendrasurian
AU - Liew, Mun Thing
AU - Wong, Siong Ling Danny
AU - Fong, Kean Khang
AU - Rahman, Hamizah Bt Abdul
AU - Noor, Zuraini Md
AU - Tong, Lee Kok
AU - Azman, Abd. Hamid
AU - Mazlan, Mohd Zulfakar
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AU - Singer, Pierre
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AU - Rigler, Merav
AU - Belman, Daniel
AU - Levin, Phillip
AU - Harara, Belal
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AU - Abillama, Fayez
AU - Abilama, Fayez
AU - Ibrahim, Rebecca
AU - Fares, Aya
AU - Elhadi, Muhammed
AU - Buimsaedah, Ahmad
AU - Gamra, Marwa
AU - Aqeelah, Ahmed
AU - AliAli, Almajdoub Mohammed
AU - Homaidan, Ahmed Gaber Sadik
AU - Almiqlash, Bushray
AU - Bilkhayr, Hala
AU - Bouhuwaish, Ahmad
AU - Taher, Ahmed Sa
AU - Abdulwahed, Eman
AU - Abousnina, Fathi A.
AU - Hdada, Aisha Khaled
AU - Jobran, Rania
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AU - Abidi, Khalid
AU - Serghini, Issam
AU - Seddiki, Rachid
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AU - Mouhssine, Doumiri
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AU - Dendane, Tarek
AU - Zeggwagh, Amine Ali
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AU - Jayyab, Mustafa Abu
AU - Aithssain, Ali
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AU - Elbuzidi, Abdurahaman
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AU - Nissar, Shaikh
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AU - Almekhlafi, Ghaleb A.
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AU - Aljabbary, Ahmed
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AU - Abu-Sayf, Natalia
AU - Al-Jadaan, Mohammad
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AU - Bouaziz, Mounir
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AU - Montefiore, Yanina Nuccetelli Pablo
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AU - Castillo, Roberto Alejandro
AU - Leal, Jesús Nicolás Pantoja
AU - Aguilar, Candy Garcia
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AU - Lomeli-Teran, Manuel
AU - Dominguez-Cherit, Jose G.
AU - Ñamendys-Silva, Adrian Davalos-AlvarezSilvio A.
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AU - Tejeda-Huezo, Brigitte
AU - Tomas, Orlando R. Perez-Nieto Ernesto Delo
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AU - De Bus, Guy FrancoisLiesbet
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AU - Haentjens, Lionel
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AU - Misset, Nathalie Layos Benoît
AU - De Schryver Nicolas Serck, Nicolas
AU - De Waele, Xavier Wittebole Elisabeth
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AU - Kovacevic, Pedja
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AU - Zlojutro, Biljana
AU - Filipovic-Grcic, Ina
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AU - Zappella, Jean-François Timsit N.
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AU - Louis, Guillaume
AU - Smonig, Roland
AU - Baudry, Laurent Argaud Thomas
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AU - Yakubu, Saidu Yusuf
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AU - Mer, Mervyn
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A2 - Ruckly, Stephane
A2 - Akova, Murat
N1 - Publisher Copyright: © 2025. Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2025/4/7
Y1 - 2025/4/7
N2 - INTRODUCTION: Hospital-acquired bloodstream infections (HA-BSIs) are severe and require antibiotic therapy. In non-complicated BSIs, shortened therapy reduces side effects without compromising efficacy. The impact of shortened antibiotic therapy in HA-BSI critically ill patients without indication of prolonged therapy requires further evaluation. METHODS: Using the international prospective EUROBACT-2 cohort, we compared shortened (7-10 days) versus long (14-21 days) treatment durations in ICU patients eligible for shortened therapy. Patients without antibiotic therapy within 3 days after HA-BSI occurrence or requiring prolonged therapy (due to infection source, microorganism, or clinical deterioration) were excluded. Treatment failure, defined as death, persistent infection, or subsequent infectious complications by Day 28, was assessed using an inverse-probability of treatment weighted (IPTW) logistic regression. RESULTS: Among 2600 patients, 550 were eligible for shortened treatment, 213 received short, and 337 received long treatment. The most common infection source was intravascular catheters (33%), most common microorganisms were Enterobacterales (39%). Patients with long treatment were more frequently infected with Staphylococcus aureus (11% vs. 5.6%, p = 0.025) or difficult-to-treat microorganisms (23% vs. 7%, p < 0.001), and received more commonly combination therapy (46% vs. 30%, p < 0.001). Short treatment was associated with reduced 28-day treatment failure (OR 0.64, 95% CI 0.44-0.93, p = 0.019), mainly due to reduction in subsequent infectious complications (OR 0.58, 95% CI 0.37-0.91, p = 0.018). Mortality (OR 0.92 [95% CI 0.59, 1.43], p = 0.7) and persistent infection rates (OR 0.47 [95% CI 0.17, 1.14], p = 0.12) were similar. CONCLUSIONS: In selected ICU patients with HA-BSI, shortened antibiotic treatment might be considered. Eurobact2 was a prospective international cohort study, registered in ClinicalTrials.org (NCT03937245).
AB - INTRODUCTION: Hospital-acquired bloodstream infections (HA-BSIs) are severe and require antibiotic therapy. In non-complicated BSIs, shortened therapy reduces side effects without compromising efficacy. The impact of shortened antibiotic therapy in HA-BSI critically ill patients without indication of prolonged therapy requires further evaluation. METHODS: Using the international prospective EUROBACT-2 cohort, we compared shortened (7-10 days) versus long (14-21 days) treatment durations in ICU patients eligible for shortened therapy. Patients without antibiotic therapy within 3 days after HA-BSI occurrence or requiring prolonged therapy (due to infection source, microorganism, or clinical deterioration) were excluded. Treatment failure, defined as death, persistent infection, or subsequent infectious complications by Day 28, was assessed using an inverse-probability of treatment weighted (IPTW) logistic regression. RESULTS: Among 2600 patients, 550 were eligible for shortened treatment, 213 received short, and 337 received long treatment. The most common infection source was intravascular catheters (33%), most common microorganisms were Enterobacterales (39%). Patients with long treatment were more frequently infected with Staphylococcus aureus (11% vs. 5.6%, p = 0.025) or difficult-to-treat microorganisms (23% vs. 7%, p < 0.001), and received more commonly combination therapy (46% vs. 30%, p < 0.001). Short treatment was associated with reduced 28-day treatment failure (OR 0.64, 95% CI 0.44-0.93, p = 0.019), mainly due to reduction in subsequent infectious complications (OR 0.58, 95% CI 0.37-0.91, p = 0.018). Mortality (OR 0.92 [95% CI 0.59, 1.43], p = 0.7) and persistent infection rates (OR 0.47 [95% CI 0.17, 1.14], p = 0.12) were similar. CONCLUSIONS: In selected ICU patients with HA-BSI, shortened antibiotic treatment might be considered. Eurobact2 was a prospective international cohort study, registered in ClinicalTrials.org (NCT03937245).
UR - https://www.scopus.com/pages/publications/105003917128
U2 - 10.1007/s00134-025-07857-6
DO - 10.1007/s00134-025-07857-6
M3 - Artículo
SN - 0342-4642
VL - 51
SP - 518
EP - 528
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 3
M1 - N/A
ER -
Gajdos L, Buetti N, Tabah A, Ruckly S, Akova M, Sjöval F et al. Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database. Intensive Care Medicine. 2025 abr. 7;51(3):518-528. N/A. doi: 10.1007/s00134-025-07857-6