Optimal duration of antimicrobial therapy for uncomplicated Gram-negative bloodstream infections.


PURPOSE:Optimal antimicrobial treatment duration for Gram-negative bloodstream infection (BSI) remains unclear. This retrospective cohort study examined effectiveness of short (7-10 days) and long (>10 days) courses of antimicrobial therapy for uncomplicated Gram-negative BSI. METHODS:Hospitalized adults with uncomplicated Gram-negative BSI at Palmetto Health hospitals in Columbia SC, USA from January 1, 2010 to December 31, 2013 were identified. Multivariate Cox proportional hazards regression with propensity score adjustment was used to examine risk of treatment failure in the two groups. RESULTS:During the study period, 117 and 294 patients received short and long courses of antimicrobial therapy for uncomplicated Gram-negative BSI, respectively. Overall, the median age was 67 years, 258 (63%) were women, 282 (69%) had urinary source of infection, and 271 (66%) had BSI due to Escherichia coli. The median duration of antimicrobial therapy was 8.5 and 13.3 days in the short and long treatment groups, respectively. After adjustment for the propensity to use a short course of therapy, risk of treatment failure was higher in patients receiving short compared to long courses of antimicrobial agents (HR 2.60, 95% CI: 1.20-5.53, p = 0.02). Other risk factors for treatment failure included liver cirrhosis (HR 5.83, 95% CI: 1.89-15.02, p = 0.004) and immune compromised status (HR 4.30, 95% CI: 1.57-10.80, p = 0.006). Definitive antimicrobial therapy with intravenous or highly bioavailable oral agents was associated with reduced risk of treatment failure (HR 0.33, 95% CI: 0.14-0.73, p = 0.006). CONCLUSIONS:The current results support common clinical practice of 2 weeks of antimicrobial therapy for uncomplicated Gram-negative BSI.






Nelson AN,Justo JA,Bookstaver PB,Kohn J,Albrecht H,Al-Hasan MN




Has Abstract


2017-10-01 00:00:00














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    pub_type: 杂志文章


    authors: Smit J,Rieg SR,Wendel AF,Kern WV,Seifert H,Schønheyder HC,Kaasch AJ

    更新日期:2018-10-01 00:00:00

  • IL-6 and TNF alpha release in association with neutrophil activation after cardiopulmonary bypass surgery.

    abstract::The serum IL-6 and TNF alpha response to cardiopulmonary bypass surgery was studied in 12 patients. Human neutrophil elastase was also measured in order to detect the presence of neutrophil activation. Peripheral venous blood samples were obtained before, during, and 1, 2, 3 and 6 days after surgery. Intra-operative s...


    pub_type: 杂志文章


    authors: Holzheimer RG,Molloy RG,Görlach H,Wilkert S,Hehrlein F

    更新日期:1994-01-01 00:00:00

  • Is aciclovir prophylaxis necessary after bone marrow transplantation?

    abstract::To assess the cost-effect relationship of aciclovir prophylaxis versus early treatment, we performed a retrospective study in 44 allogeneic bone marrow transplant recipients, who had only received aciclovir for therapeutic purposes. After bone marrow transplantation 18 herpes simplex infections occurred in 15 of the 3...


    pub_type: 杂志文章


    authors: Sinnige LG,van der Meer JW,Gratama JW,Versteeg J,Zwaan FE

    更新日期:1986-05-01 00:00:00

  • Serious complications of tuberculous epididymitis.

    abstract::Tuberculous epididymitis is a rare entity associated with minor complications. We present two cases of tuberculous epididymitis associated with serious complications (bilateral psoas abscesses and Addison's disease with psoas abscess). A review of the literature disclosed six additional cases associated with serious c...


    pub_type: 杂志文章,评审


    authors: Skoutelis A,Marangos M,Petsas T,Chionis I,Barbalias G,Bassaris H

    更新日期:2000-05-01 00:00:00

  • Ventriculitis caused by Klebsiella pneumoniae successfully treated with pefloxacin in a neonate.

    abstract::Pefloxacin was applied to a newborn suffering from ventriculitis caused by Klebsiella pneumoniae after failure of routine antibiotics. Treatment was successful. Blood and CSF levels were high, thus documenting good CSF penetration. In addition to this case report, a review of the literature regarding seven neonates wi...


    pub_type: 杂志文章,评审


    authors: Linder N,Dagan R,Kuint J,Keler N,Keren G,Reichman B

    更新日期:1994-05-01 00:00:00

  • Safety and immunogenicity of early vaccination with two doses of tetravalent measles-mumps-rubella-varicella (MMRV) vaccine in healthy children from 9 months of age.

    abstract:BACKGROUND:This open, randomized, controlled study [208136/018] assessed the safety and immunogenicity of early vaccination with an experimental tetravalent measles-mumps-rubella-varicella (MMRV) vaccine (GlaxoSmithKline Biologicals) compared to concomitant administration of separate licensed MMR (Priorix) and varicell...


    pub_type: 杂志文章,随机对照试验


    authors: Goh P,Lim FS,Han HH,Willems P

    更新日期:2007-10-01 00:00:00

  • [Microbiological diagnosis of septicemia].

    abstract::To detect microorganisms in the blood it is necessary not only that the microbiologist uses reliable methods, but also that the clinician takes a sufficient number of blood samples at the right point in time using a correct method for drawing the blood. The best results are obtained if the blood sample is transferred ...


    pub_type: 杂志文章


    authors: Rotter M

    更新日期:1977-03-01 00:00:00

  • Treatment of Lyme arthritis.

    abstract::The efficacy of different therapeutic regimens for Lyme arthritis is reviewed. The first treatment for Lyme arthritis, intramuscular benzathine penicillin 2.4 million units weekly for 3 weeks, had a success rate of 35%. Another study employed intravenous penicillin G at a dosage of 20 million units daily for 10 days, ...


    pub_type: 杂志文章,评审


    authors: Cimmino MA,Moggiana GL,Parisi M,Accardo S

    更新日期:1996-01-01 00:00:00

  • Chlamydia trachomatis in andrologic patients--direct and indirect detection.

    abstract:BACKGROUND:Chlamydia trachomatis is considered to be the most common sexually transmitted disease in Germany. It is currently unclear whether chlamydial infection causes pathological conditions of the male accessory glands with consequences for male infertility. PATIENTS AND METHODS:Within the framework of several pro...


    pub_type: 杂志文章


    authors: Bollmann R,Engel S,Petzoldt R,Göbel UB

    更新日期:2001-05-01 00:00:00

  • Risk factors for infective endocarditis in patients with enterococcal bacteremia: a case-control study.

    abstract:BACKGROUND:Based on previous studies, enterococcal infective endocarditis (IE) is considered a unimicrobial, community-acquired disease of older Caucasian men. PATIENTS AND METHODS:We evaluated the relationship between enterococcal bacteremia and IE by comparing clinical and demographic characteristics of all cases of...


    pub_type: 杂志文章


    authors: Anderson DJ,Murdoch DR,Sexton DJ,Reller LB,Stout JE,Cabell CH,Corey GR

    更新日期:2004-04-01 00:00:00

  • Therapeutic drug monitoring of aminoglycoside antibiotics.

    abstract::Aminoglycosides are widely used antibacterial agents, particularly for serious infections. They have a narrow therapeutic margin of efficacy over toxicity relative to many other agents, a disadvantage which can be obviated to some extent by precise dosing regulated by blood concentration monitoring. The relationships ...


    pub_type: 杂志文章,评审


    authors: Reeves DS

    更新日期:1980-01-01 00:00:00

  • Influence of aminopenicillins on bacterial growth kinetics in vitro in comparison with the antibacterial effect in vivo.

    abstract::To quantify the relative antibacterial efficacy of beta-lactam antibiotics in vitro, a mathematical description of bacterial growth was developed. Curves of growth in the presence of the antibiotic are expressed as quadratic functions of time, with initial growth rate (ko) and rate of change of growth (a) as concentra...


    pub_type: 杂志文章


    authors: Mattie H,van der Voet GB

    更新日期:1979-01-01 00:00:00

  • High prevalence of latent tuberculosis infection in patients in end-stage renal disease on hemodialysis: Comparison of QuantiFERON-TB GOLD, ELISPOT, and tuberculin skin test.

    abstract:BACKGROUND:Individuals with end-stage renal disease (ESRD) are 10- to 25-fold more likely than immunocompetent people to develop active tuberculosis (TB) and are candidates for being treated for latent TB infection (LTBI). However, diagnosis using the tuberculin skin test (TST) is doubly difficult due to cutaneous aner...


    pub_type: 杂志文章


    authors: Lee SS,Chou KJ,Su IJ,Chen YS,Fang HC,Huang TS,Tsai HC,Wann SR,Lin HH,Liu YC

    更新日期:2009-04-01 00:00:00

  • [A microbiological method for the rapid determination of antibiotic concentrations during therapy].

    abstract::The assay described is an agar diffusion test using Bacillus stearothermophilus as test organism. Incubation is at 62° C; results can be obtained rapidly within 2 to 3 hours. The test was developed for the determination of gentamicin concentrations in serum and other body fluids. Because of its high sensitivity the te...


    pub_type: 杂志文章


    authors: Wahlig H

    更新日期:1977-06-01 00:00:00

  • Clindamycin-induced hypersensitivity reaction.

    abstract::Drug-induced anaphylaxis is an unpredictable adverse reaction. Although it may occur with any medication, antibiotics induce more cases of anaphylaxis than any other medication class with most cases being induced by β-lactam antibiotics. Clindamycin is an antibiotic with good gram-positive and anaerobe coverage which ...


    pub_type: 杂志文章


    authors: Bulloch MN,Baccas JT,Arnold S

    更新日期:2016-06-01 00:00:00

  • Analysis of the specific immune response against capsular polysaccharides of two patients with systemic enterococcal infections.

    abstract::Systemic enterococcal infections often lead to life-threatening disease. By analyzing the immune response of two patients with systemic enterococcal infections against enterococcal polysaccharide antigens, we found that both patients had antibodies against all four of the capsular serotypes identified to date. Antibod...


    pub_type: 杂志文章


    authors: Hufnagel M,Huebner J

    更新日期:2005-10-01 00:00:00

  • A prospective study on infectious mononucleosis in childhood--symptoms, serology, Epstein-Barr-Virus specific leukocyte migration inhibition.

    abstract::The clinical course, serological changes and the development of the specific cell-mediated immune response to Epstein-Barr-Virus (EBV), measured in terms of leukocyte migration inhibition, were followed in 40 children suffering from an EBV infection. The patients were followed for between six and 24 months. Although t...


    pub_type: 杂志文章


    authors: Timár L,Budai J,Koller M

    更新日期:1982-01-01 00:00:00

  • Antibacterial activity and kill kinetics of amoxicillin-clavulanic acid combinations against Escherichia coli and Klebsiella aerogenes.

    abstract::Combinations of amoxicillin and clavulanic acid were tested against 11 Escherichia coli strains and five Klebsiella aerogenes strains. Apart from one E. coli, the strains were highly resistant to amoxicillin due to beta-lactamase production. Synergy was demonstrated in all strains by agar dilution. Synergy was detecte...


    pub_type: 杂志文章


    authors: Fuglesang JE,Bergan T

    更新日期:1983-11-01 00:00:00

  • Congenital rubella syndrome after maternal reinfection.

    abstract::This report concerns a case of congenital rubella syndrome (CRS) with atypical immune response affecting an infant whose mother had repeated evidence of immunity before pregnancy. Laboratory diagnosis of CRS could only clearly be achieved by virus isolation after the second month of life despite typical clinical featu...


    pub_type: 杂志文章


    authors: Weber B,Enders G,Schlösser R,Wegerich B,Koenig R,Rabenau H,Doerr HW

    更新日期:1993-03-01 00:00:00

  • Brucellosis: difficulties in diagnosis and a report on 38 cases.

    abstract::We have reviewed 38 patients with brucellosis who were admitted to the Chaim Sheba Medical Center between 1955 and 1977, i.e. during a 23-year period. The clinical manifestations varied greatly. Diagnosis was easy when brucellosis was suspected, as in cases presenting with fever of unknown origin. In nine of the 38 ca...


    pub_type: 杂志文章


    authors: Samra Y,Shaked Y,Hertz M,Altman G

    更新日期:1983-11-01 00:00:00

  • Effect of 17 beta-estradiol on adherence of Escherichia coli to human endometrial stromal cells.

    abstract::The effect of 17 beta-estradiol on in vitro adherence of six strains of uropathic Escherichia coli to human endometrial stromal cells was examined. In contrast to the findings of earlier investigations using murine urogenital cells and malignant human urogenital cell lines, our studies showed no significant effect of ...


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    authors: Mackowiak PA,Goggans ML

    更新日期:1989-03-01 00:00:00

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    abstract:: ...


    pub_type: 社论


    authors: Bogner JR

    更新日期:2018-12-01 00:00:00

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    pub_type: 杂志文章


    authors: Cevik M,Moncayo-Nieto OL,Evans MJ

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    pub_type: 杂志文章


    authors: Rosenthal R,Vogelbach P,Gasser M,Zimmerli W

    更新日期:2001-05-01 00:00:00

  • Clinical characteristics and antibiotic susceptibility of viridans streptococcal bacteremia in children with febrile neutropenia.

    abstract:PURPOSE:This retrospective study was performed in order to investigate the clinical characteristics and antibiotic susceptibility of viridans streptococcal bacteremia (VSB) in febrile neutropenic children in the context of the increase in incidence and antibiotic resistance of VSB. METHODS:We conducted this study amon...


    pub_type: 杂志文章


    authors: Han SB,Bae EY,Lee JW,Lee DG,Chung NG,Jeong DC,Cho B,Kang JH,Kim HK

    更新日期:2013-10-01 00:00:00

  • Recommendations for the management of acute hepatitis B: position paper of the Italian Society for the Study of Infectious and Tropical Diseases (SIMIT).

    abstract:PURPOSE:To develop recommendations for the management of acute hepatitis B by the Italian Society for the Study of Infectious and Tropical Diseases. METHODS:Development of the recommendations divided into three levels of evidence according to the GRADE system: A (high), B (medium) and C (low experts opinion), together...


    pub_type: 杂志文章,实务指引,评审


    authors: Bruno R,Carosi G,Coppola N,Gaeta GB,Puoti M,Santantonio T,Taliani G,Armignacco O,Sagnelli E,Andreoni M,Angarano G,Di Perri G,D'Offizi G,Galli M,Rizzardini G,Italian Society for the Study of Infectious and Tropical Diseases.

    更新日期:2014-10-01 00:00:00

  • HHV6 meningoencephalitis sequelae in previously healthy children.

    abstract:INTRODUCTION:Human herpes virus 6 (HHV6) infection is a self-limiting illness occurring in early childhood. As with other herpes viruses, the encephalopathy associated with HHV6 is often attributable to the reactivation of a virus previously latent in human brain tissue. Previous reports on HHV6 encephalopathy dealt ma...


    pub_type: 杂志文章


    authors: Bozzola E,Krzysztofiak A,Bozzola M,Calcaterra V,Quondamcarlo A,Lancella L,Villani A

    更新日期:2012-10-01 00:00:00

  • Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 11 adult intensive care units from 10 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC).

    abstract:PURPOSE:To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey. METH...


    pub_type: 杂志文章,多中心研究


    authors: Leblebicioglu H,Yalcin AN,Rosenthal VD,Koksal I,Sirmatel F,Unal S,Turgut H,Ozdemir D,Ersoz G,Uzun C,Ulusoy S,Esen S,Ulger F,Dilek A,Yilmaz H,Turhan O,Gunay N,Gumus E,Dursun O,Yýlmaz G,Kaya S,Ulusoy H,Cengiz M

    更新日期:2013-04-01 00:00:00

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    pub_type: 杂志文章


    authors: Kumon H

    更新日期:1992-01-01 00:00:00

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    authors: Taj-Aldeen SJ,Kolecka A,Boesten R,Alolaqi A,Almaslamani M,Chandra P,Meis JF,Boekhout T

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