1. Trial of Short-Course Antimicrobial Therapy for Intraabdominal Infection
- Author
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Sawyer, Robert G, Claridge, Jeffrey A, Nathens, Avery B, Rotstein, Ori D, Duane, Therese M, Evans, Heather L, Cook, Charles H, O'Neill, Patrick J, Mazuski, John E, Askari, Reza, Wilson, Mark A, Napolitano, Lena M, Namias, Nicholas, Miller, Preston R, Dellinger, E Patchen, Watson, Christopher M, Coimbra, Raul, Dent, Daniel L, Lowry, Stephen F, Cocanour, Christine S, West, Michaela A, Banton, Kaysie L, Cheadle, William G, Lipsett, Pamela A, Guidry, Christopher A, Popovsky, Kimberley, and STOP-IT Trial Investigators
- Subjects
Adult ,Male ,medicine.medical_specialty ,Fever ,Adolescent ,Leukocytosis ,medicine.drug_class ,Antibiotics ,Peritonitis ,Kaplan-Meier Estimate ,and over ,Medical and Health Sciences ,Drug Administration Schedule ,Medication Adherence ,law.invention ,Sepsis ,Young Adult ,Randomized controlled trial ,Recurrence ,Interquartile range ,law ,General & Internal Medicine ,Internal medicine ,80 and over ,medicine ,Humans ,Surgical Wound Infection ,Aged ,Aged, 80 and over ,business.industry ,General Medicine ,Middle Aged ,Appendicitis ,medicine.disease ,Confidence interval ,Anti-Bacterial Agents ,Surgery ,Intraabdominal Infections ,Female ,STOP-IT Trial Investigators ,medicine.symptom ,business - Abstract
BackgroundThe successful treatment of intraabdominal infection requires a combination of anatomical source control and antibiotics. The appropriate duration of antimicrobial therapy remains unclear.MethodsWe randomly assigned 518 patients with complicated intraabdominal infection and adequate source control to receive antibiotics until 2 days after the resolution of fever, leukocytosis, and ileus, with a maximum of 10 days of therapy (control group), or to receive a fixed course of antibiotics (experimental group) for 4±1 calendar days. The primary outcome was a composite of surgical-site infection, recurrent intraabdominal infection, or death within 30 days after the index source-control procedure, according to treatment group. Secondary outcomes included the duration of therapy and rates of subsequent infections.ResultsSurgical-site infection, recurrent intraabdominal infection, or death occurred in 56 of 257 patients in the experimental group (21.8%), as compared with 58 of 260 patients in the control group (22.3%) (absolute difference, -0.5 percentage point; 95% confidence interval [CI], -7.0 to 8.0; P=0.92). The median duration of antibiotic therapy was 4.0 days (interquartile range, 4.0 to 5.0) in the experimental group, as compared with 8.0 days (interquartile range, 5.0 to 10.0) in the control group (absolute difference, -4.0 days; 95% CI, -4.7 to -3.3; P
- Published
- 2015