Long-Term Outcomes Following Suppressive Antibiotic Therapy: A 10-Year Cohort Study

Area of Science:

• Infectious Diseases
• Pharmacology
• Clinical Medicine

Background:

• Lifelong antibiotic therapy is a strategy for incurable chronic infections.
• Long-term consequences of this approach are not well understood.
• This study investigates the outcomes of long-term antibiotic use.

Purpose of the Study:

• To evaluate the 10-year outcomes of patients on suppressive long-term antibiotics.
• To assess mortality, adverse events, and therapy adherence.
• To understand the complexities and challenges of lifelong antibiotic management.

Main Methods:

• A 10-year longitudinal observational study (2015-2025) in Melbourne, Australia.
• Followed an initial cohort of 29 patients on long-term antibiotics.
• Extracted data on demographics, antibiotic use, adverse events, mortality, and Charlson Comorbidity Index.

Main Results:

• After 10 years, 11/29 patients (38%) had died.
• Only 7/29 patients remained on antimicrobials at the 10-year follow-up.
• None of the patients who ceased antibiotics resumed therapy; challenges included comorbidities and hospitalizations.

Conclusions:

• Lifelong antibiotic therapy presents complex challenges despite potential benefits in preventing infection relapse.
• High comorbidity burden, therapy adjustments, and hospitalizations are significant issues.
• Individualized treatment and further research are crucial for optimizing long-term antibiotic management.