Category: Federal Forum Posters
Purpose: The optimal treatment duration for bacteremia caused by gram negative organisms has not been clearly elucidated. There is conflicting data related to treatment duration as well as the influence of oral antibiotic bioavailability on patient outcomes. The purpose of this study will be to compare short and long durations of treatment for patients with gram negative bacteremia due to urinary source in order to determine a duration of therapy which will optimize clinical efficacy and minimize antibiotic exposure. This study will also examine when intravenous to oral conversion is appropriate with consideration to high and low bioavailability antibiotics.
Methods: This is a retrospective cohort study of patients hospitalized at the Veteran Affairs Western New York Healthcare System (VA WNY HCS) from June 2008 to June 2018. Patients will be included if they are 18 years of age and older presenting with a positive blood culture for E coli, Klebsiella, Enterobacter, Proteus, Citrobacter, Pseudomonas, or Acinetobacter species relating to urinary source. Outcome measures of interest are 30-day mortality, recurrence of bacteremia within 3 months, length of stay, emergence of Clostridium difficile infection, emergence of multidrug resistant pathogens, and rates of positive follow up blood cultures. Duration of intravenous antibiotics vs. oral and the bioavailability of such will be examined for each of the above outcomes. Statistical analysis will include multivariate Cox proportional hazards regression to examine the risk of treatment failure between long and short duration. Kaplan- Meier survival will be performed to assess failure rates within 3 months in the different bioavailability groups.
Results: Not applicable
Conclusion: Not applicable
Katrina Eldridge– Pharmacy Resident, VA Western New York Healthcare System, Buffalo, NY