Top Questions in Uncomplicated, Non–Staphylococcus aureus Bacteremia

Abstract

The Infectious Diseases Society of America infection-specific guidelines provide limited guidance on the management of focal infections complicated by secondary bacteremias. We address the following 3 commonly encountered questions and management considerations regarding uncomplicated bacteremia not due to Staphylococcus aureus: the role and choice of oral antibiotics focusing on oral beta-lactams, the shortest effective duration of therapy, and the role of repeat blood cultures.

Bacteremia complicates approximately 2%–25% of focal infections, such as pneumonia and urinary tract infection (UTI), managed in the hospital and may be associated with poor outcomes [12]. Most infection-specific Infectious Diseases Society of America (IDSA) guidelines do not provide direct management recommendations for choice or route of antibiotic administration, duration of therapy, or use of repeat blood cultures in secondary bacteremias [34]. Until recently, few studies evaluated these common management considerations, and the available literature suggests that considerable practice variation exists [5–7]. Use of the least invasive route of antibiotic administration and the shortest effective duration of therapy are imperative given the relationship between route and duration of antibiotic exposure and adverse drug events, Clostridium difficile infections, and antibiotic resistance [8–11]. Given these considerations, we aim to briefly summarize the existing literature regarding 3 management considerations in uncomplicated bacteremia not due to Staphylococcus aureus in adults: (1) the role and choice of oral antibiotics focusing on beta-lactams, (2) the shortest effective duration of therapy, and (3) the role of repeat blood cultures. No standard definition of uncomplicated bacteremia exists; therefore, we use uncomplicated bacteremia to refer to immunocompetent, bacteremic patients without an uncontrolled source of infection or deep-seated infection for which treatment durations greater than 2 weeks are routinely recommended [31213].

Read more…

 

By |2018-05-17T11:42:46+00:00May 17th, 2018|

Leave A Comment