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Fixed-Course Antibiotics Good for Intraabdominal Infection

Outcomes similar for fixed-duration abx therapy, therapy extended through symptom resolution

WEDNESDAY, May 20, 2015 (HealthDay News) — For patients with complicated intraabdominal infection, outcomes are similar for fixed-duration antibiotic therapy and antibiotic therapy that is extended until symptom resolution, according to a study published in the May 21 issue of the New England Journal of Medicine.

Robert G. Sawyer, M.D., from the University of Virginia Health System in Charlottesville, and colleagues randomized 518 patients with complicated intraabdominal infection and adequate source control to receive antibiotics until two days after the resolution of fever, leukocytosis, and ileus (control) or a fixed course of antibiotics (experimental group) for four days.

The researchers found that 21.8 percent of the experimental group and 22.3 percent of the control group had surgical-site infection, recurrent intraabdominal infection, or death (P = 0.92). The median duration of antibiotic therapy was 4.0 and 8.0 days in the experimental and control groups, respectively (P < 0.001). There were no significant differences between the groups with respect to the individual rates of the components of the primary outcome or other secondary outcomes.

“Outcomes in patients with intraabdominal infections who have undergone a successful source-control procedure and receive a fixed, four-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 authors write.

Several authors disclosed financial ties to pharmaceutical companies.

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