Related Experiment Videos
Long-term suppressive antimicrobial therapy for intravascular device-related infections
1Department of Medicine, Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, 37920-6999, USA. lbaddour@mc.utmck.edu
Background:
Long-term suppressive antimicrobial therapy is an alternative treatment choice in patients with medical device-related infection who are not eligible for surgical device removal for attempted cure. There is a paucity of data published that examines this treatment option.
Methods:
Members of the Infectious Diseases Society of America's Emerging Infections Network were polled to identify patients with intravascular device-related infections who were not candidates for surgery and were given long-term antimicrobial therapy to suppress clinical manifestations of infection.
Results:
Clinical and microbiologic data were collected retrospectively for 51 patients. Sixty-nine percent of patients were men; vascular grafts were the most common type of medical device infected [30 (58.8%) patients]. Sixty-three percent (32 of 51) of cases involved gram-positive cocci. A variety of antimicrobials were administered as chronic suppressive therapy, with beta-lactams used most frequently (39.2%). Therapy ranged from 3 months to 10 years. Three (7.32%) of 41 patients in whom follow-up data were available developed relapsing infection while on long-term suppressive therapy. Three other patients suffered drug adverse events.
Conclusions:
Overall, long-term suppressive therapy was well-tolerated and efficacious in preventing signs of infection relapse.
Insights
Long-term suppressive antimicrobial therapy effectively manages medical device infections in patients ineligible for surgery. This approach was well-tolerated and prevented infection relapses in most cases.
Area of Science:
- Infectious Diseases
- Antimicrobial Therapy
- Medical Device Infections
Background:
- Long-term suppressive antimicrobial therapy is an option for patients with medical device-related infections unable to undergo surgical removal.
- Limited data exist on the efficacy and tolerability of this treatment strategy.
Purpose of the Study:
- To evaluate the outcomes of long-term antimicrobial therapy for patients with medical device-related infections who were not candidates for surgery.
- To assess the efficacy and safety of suppressive antimicrobial treatment in this patient population.
Main Methods:
- A retrospective poll of the Infectious Diseases Society of America's Emerging Infections Network identified relevant patients.
- Clinical and microbiologic data were collected for 51 patients with intravascular device-related infections managed without surgery.
- Antimicrobial agents and treatment durations were recorded.
Main Results:
- Vascular graft infections were most common (58.8%), with Gram-positive cocci predominating (63%).
- Beta-lactams were the most frequently used suppressive agents (39.2%).
- Relapse occurred in 7.32% of patients with available follow-up data; three patients experienced drug adverse events.
Conclusions:
- Long-term suppressive antimicrobial therapy is a well-tolerated and effective strategy for preventing infection relapse in patients with medical device-related infections.
- This approach offers a viable alternative for patients unsuitable for surgical intervention.