Abstract

Background: A proper duration for treating patients with Enterobacteriaceae bloodstream infection is not yet well defined; we attempt to find the appropriate course of treatment.

Methods: A retrospective multicenter study in Amman-Jordan. Medical records were reviewed for patients with blood cultures growth for Enterobacteriaceae. Information on blood cultures was extracted from the microbiology logbook and records. For adults >18 years, primary bacteremia and a known source were included. Patients who needed prolonged antibiotics treatment due to the nature of their infections and zoonotic infections, neutropenic cancer patients, organs with abscesses/empyema, CVC retention, polymicrobial septicemia, and expected survival ≤ 48 hours were excluded. Continuous variables were analyzed by (χ²), ANOVA for means, and the Bonferroni for pairwise comparisons if P-value is <0.05.

Results: 323 Patients with Enterobacteriaceae growth on blood cultures were distributed as follows: patients with one-week treatment duration were 163, two-week 102, and three-week duration was 58. Characteristics were balanced among the three durations (P>0.05) except male gender; diabetes, steroids, CVC, and a few antibiotics were more in the three-week treatment (P<0.05). All-cause mortality, relapse, and reinfection did not differ significantly among the three treatment durations (P>0.05). The relapse rate in 90 days was 5.17%, and the reinfection rate was 4.3%.

Conclusion: There was no significant difference in the three antibiotics treatment durations in the 28-day, 90-day all-cause mortality rates, relapse, and reinfection rates.

Keywords: All-cause 28-day mortality; All-cause 90-day mortality; Bloodstream infection; Duration of antibiotic therapy; Enterobacteriaceae