Duration of antibiotic therapy in Gram-negative infections with a particular focus on multidrug-resistant pathogens
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Lippincott Williams and Wilkins
Abstract
Purpose of reviewAntimicrobial overuse is a major health problem that contributes to antimicrobial resistance (AMR). Infections with Gram-negative bacilli (GNB) and multidrug-resistant organisms (MDRs) are associated with high morbidity and mortality, particularly in patients with underlying medical conditions.Recent findingsAlthough many recent studies have been published about the novel antibiotics in treating infections including those due to MDR-GNB, the optimal duration of treatment (DOT) remains inconclusive. Recent observation has supported that short antibiotic therapy (SAT) decreases AMR and adverse effects. This narrative review provides an overview of the most recent published studies on the duration of therapy in the treatment of GNB infections, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), intra-abdominal infections (IAIs), bloodstream infections (BSIs) and urinary tract infections (UTIs), with a particular focus on MDR-GNB.SummaryStudies showed different outcomes when comparing SAT to long antimicrobial therapy (LAT). No generalization can be made on all sites of infections and different GNBs. Further studies are needed to address the optimal DOT in MDR-GNB, as this group is underrepresented in recent studies. © 2022 Lippincott Williams and Wilkins. All rights reserved.
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Bloodstream infections, Duration of antibiotic therapy, Gram-negative bacilli, Hospital-acquired and ventilator-associated pneumonia, Intra-abdominal infections, Multidrug-resistant gram-negative bacteria, Urinary tract infections, Anti-bacterial agents, Cross infection, Drug resistance, multiple, bacterial, Gram-negative bacteria, Gram-negative bacterial infections, Humans, Pneumonia, ventilator-associated, Antibiotic agent, Antiinfective agent, Abdominal infection, Adult, All cause mortality, Antibiotic therapy, Antimicrobial therapy, Bloodstream infection, Decision making, Follow up, Gram negative infection, High risk population, Hospital acquired pneumonia, Human, Immune deficiency, Multidrug resistance, Multidrug resistant gram negative bacterium, Nonhuman, Patient care, Review, Treatment duration, Urinary tract infection, Ventilator associated pneumonia, Gram negative bacterium