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Shortened IV Antibiotic Course for Uncomplicated, Late-Onset Group B Streptococcal Bacteremia

Eric R Coon1,2, Raj Srivastava3,2,4, Greg Stoddard2,5

  • 1Division of Inpatient Medicine, eric.coon@hsc.utah.edu.

Pediatrics
|October 13, 2018
PubMed

Insights

Shortened intravenous antibiotic courses for infant group B Streptococcus bacteremia are common and show low recurrence rates. This suggests current guidelines may be longer than necessary for uncomplicated cases.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neonatology

Background:

  • Guidelines recommend 10-day intravenous (IV) antibiotic therapy for infants with uncomplicated, late-onset group B Streptococcus (GBS) bacteremia.
  • Variability exists in the duration of IV antibiotic treatment prescribed for GBS bacteremia.

Purpose of the Study:

  • To determine the frequency of shortened IV antibiotic courses for GBS bacteremia in infants.
  • To compare GBS disease recurrence rates between prolonged and shortened IV antibiotic courses.

Main Methods:

  • Multicenter retrospective cohort study of infants (7 days to 4 months) with GBS bacteremia (2000-2015).
  • Exposure: shortened IV antibiotic therapy (≤8 days length of stay without central line).
  • Primary outcome: readmission for GBS bacteremia, meningitis, or osteomyelitis within the first year of life.
  • Analysis: propensity-adjusted, inverse probability-weighted regression models.

Main Results:

  • Of 775 infants, 21% received a shortened IV antibiotic course (≤8 days).
  • Shortened course use varied significantly by hospital (0%-67%).
  • GBS recurrence rates were similar: 1.8% for shortened courses vs. 2.3% for prolonged courses (adjusted risk difference: -0.2%).

Conclusions:

  • Shortened IV antibiotic courses are frequently prescribed for uncomplicated, late-onset GBS bacteremia.
  • Low rates of GBS recurrence and treatment failure were observed with shortened courses.

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