Clinical outcomes of a twice daily metronidazole dosing strategy for Bacteroides bloodstream infections.

Autor: Shah S; Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, PA, United States; Department of Pharmacy, University of Pittsburgh Medical Center, Pittsburgh, PA, United States; Department of Pharmacy, Yale New Haven Hospital, New Haven, CT, United States. Electronic address: sunishshah93@gmail.com., Adams K; University of Connecticut School of Pharmacy, Storrs Mansfield, CT, United States., Clarke L; Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, PA, United States; Department of Pharmacy, University of Pittsburgh Medical Center, Pittsburgh, PA, United States., Ludwig J; Office of Quality and Clinical Research Innovation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., McManus D; Department of Pharmacy, Yale New Haven Hospital, New Haven, CT, United States., Nguyen MH; Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, PA, United States; Department of Medicine, University of Pittsburgh, Pittsburgh PA, United States., Topal JE; Department of Pharmacy, Yale New Haven Hospital, New Haven, CT, United States., Shields RK; Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, PA, United States; Department of Medicine, University of Pittsburgh, Pittsburgh PA, United States.
Jazyk: angličtina
Zdroj: International journal of antimicrobial agents [Int J Antimicrob Agents] 2024 Dec 10, pp. 107403. Date of Electronic Publication: 2024 Dec 10.
DOI: 10.1016/j.ijantimicag.2024.107403
Abstrakt: Objective: The optimal metronidazole dose for the treatment of Bacteroides spp. has not been well-defined.
Methods: This study was a multicenter, retrospective chart review of adult patients with bacteremia secondary to Bacteroides spp. between October 2010 and March 2024. Clinical outcomes of patients who received 500mg of metronidazole twice daily were compared to those who received 500mg of metronidazole thrice daily. Clinical failure defined as a composite of 30-day recurrent infection due to Bacteroides spp. or all-cause mortality.
Results: Of the 242 patients who met the inclusion criteria, 76 received metronidazole 500mg twice daily and 166 received metronidazole 500mg thrice daily. Patients who received metronidazole twice daily did not have significantly different rates of clinical failure (15% vs 18%, P=0.561) or 30-day mortality (15% vs 17%, P=0.638) compared to those who received metronidazole thrice daily. After applying full-cohort matching, patients who received metronidazole twice daily were not at an increased risk of clinical failure [OR=0.859; 95% CI (0.283-2.606); P= 0.801] or 30-day mortality [OR = 0.897, 95% CI (0.292-2.752) P=0.8573].
Conclusions: In the largest study to date of patients with Bacteroides spp. bacteremia treated with metronidazole, twice daily dosing strategies were not associated with worse outcomes compared to thrice daily metronidazole dosing strategies.
Competing Interests: Conflict of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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