دورية أكاديمية
Short-course antibiotic therapy for critically ill patients treated for postoperative intra-abdominal infection: the DURAPOP randomised clinical trial
| العنوان: | Short-course antibiotic therapy for critically ill patients treated for postoperative intra-abdominal infection: the DURAPOP randomised clinical trial |
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| المؤلفون: | Montravers, Philippe, Tubach, Florence, Lescot, Thomas, Veber, Benoit, Esposito-Farèse, Marina, Seguin, Philippe, Paugam, Catherine, Lepape, Alain, Meistelman, Claude, Cousson, Joel, Tesnière, Antoine, Plantefeve, Gaetan, Blasco, Gilles, Asehnoune, Karim, Jaber, Samir, Lasocki, Sigismond, Dupont, Hervé |
| المساهمون: | Département d'Anesthésie Réanimation, AP-HP - Hôpital Bichat - Claude Bernard Paris, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département d'épidémiologie, biostatistique et recherche clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard Paris, CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Réanimation Médicale CHU Rouen, Hôpital Charles Nicolle Rouen, CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Pitié-Salpêtrière AP-HP, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Hôpital Beaujon AP-HP, Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital universitaire Robert Debré Reims (CHU Reims), Hôpital Cochin AP-HP, Centre hospitalier Argenteuil (CH Argenteuil), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Thérapeutiques cliniques et expérimentales des infections (EA 3826) (EA 3826), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Pôle d'Anesthésie Réanimation, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), PRES Université Nantes Angers Le Mans (UNAM), Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| المصدر: | ISSN: 0342-4642. |
| بيانات النشر: | HAL CCSD Springer Verlag |
| سنة النشر: | 2018 |
| المجموعة: | Université de Reims Champagne-Ardenne: Archives Ouvertes (HAL) |
| مصطلحات موضوعية: | Antibiotic therapy, Duration of therapy, Multidrug-resistant bacteria, Peritonitis, Postoperative intra-abdominal infection, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie |
| الوصف: | International audience ; Purpose: Shortening the duration of antibiotic therapy (ABT) is a key measure in antimicrobial stewardship. The optimal duration of ABT for treatment of postoperative intra-abdominal infections (PIAI) in critically ill patients is unknown.Methods: A multicentre prospective randomised trial conducted in 21 French intensive care units (ICU) between May 2011 and February 2015 compared the efficacy and safety of 8-day versus 15-day antibiotic therapy in critically ill patients with PIAI. Among 410 eligible patients (adequate source control and ABT on day 0), 249 patients were randomly assigned on day 8 to either stop ABT immediately (n = 126) or to continue ABT until day 15 (n = 123). The primary endpoint was the number of antibiotic-free days between randomisation (day 8) and day 28. Secondary outcomes were death, ICU and hospital length of stay, emergence of multidrug-resistant (MDR) bacteria and reoperation rate, with 45-day follow-up.Results: Patients treated for 8 days had a higher median number of antibiotic-free days than those treated for 15 days (15 [6–20] vs 12 [6–13] days, respectively; P < 0.0001) (Wilcoxon rank difference 4.99 days [95% CI 2.99–6.00; P < 0.0001). Equivalence was established in terms of 45-day mortality (rate difference 0.038, 95% CI − 0.013 to 0.061). Treatments did not differ in terms of ICU and hospital length of stay, emergence of MDR bacteria or reoperation rate, while subsequent drainages between day 8 and day 45 were observed following short-course ABT (P = 0.041).Conclusion: Short-course antibiotic therapy in critically ill ICU patients with PIAI reduces antibiotic exposure. Continuation of treatment until day 15 is not associated with any clinical benefit |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/29484469; hal-01816017; https://hal.umontpellier.fr/hal-01816017Test; https://hal.umontpellier.fr/hal-01816017/documentTest; https://hal.umontpellier.fr/hal-01816017/file/2018%20Montravers%20et%20al.,%20Short%20course%20antibiotic.pdfTest; PUBMED: 29484469 |
| DOI: | 10.1007/s00134-018-5088-x |
| الإتاحة: | https://doi.org/10.1007/s00134-018-5088-xTest https://hal.umontpellier.fr/hal-01816017Test https://hal.umontpellier.fr/hal-01816017/documentTest https://hal.umontpellier.fr/hal-01816017/file/2018%20Montravers%20et%20al.,%20Short%20course%20antibiotic.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.61222E9A |
| قاعدة البيانات: | BASE |
| DOI: | 10.1007/s00134-018-5088-x |
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