Short Antibiotic Course Effective Against Gastro Infection

A 4-day course of antibiotics could be just as effective as a longer, 8-day course of antibiotics in patients with intra-abdominal infections.

“Traditionally, physicians have administered antimicrobial therapy in patients who have intraabdominal infections until clinical and laboratory evidence suggests that the infection has resolved.”
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In order to better determine the appropriate length of treatment, researchers assigned 518 patients with complicated intra-abdominal infection and sufficient source control to either a fixed course of antibiotics (4± days) or antibiotics until 2 days after the resolution of ileus, leukocytosis, and fever with a maximum 10 days of therapy.

Overall, recurrent intra-abdominal infection, surgical-site infection, or death occurred in 21.8% of patients in the experimental group compared to 22.3% of the control group (58 out of 260 patients).

Note: the median duration of antibiotic therapy needed was 4 days for the experimental group and 8 dates for the control group.

“In conclusion, outcomes in patients with intra-abdominal infections who have undergone a successful source-control procedure and receive a fixed, 4-day course of antimicrobial therapy appear to be generally similar to outcomes in patients in whom systemic antimicrobial agents are administered until after the resolution of signs and symptoms of sepsis.”

The complete study is published in the May issue of the New England Journal of Medicine.

-Michelle Canales Butcher

Reference:

Sawyer RG, Claridge JA, Nathens AB, et al. Trial of short-course antimicrobial therapy for intraabdominal infection. N Engl J Med. 2015 May [epub ahead of print] doi: 10.1056/NEJMoa1411162.