Trial of short-course antimicrobial therapy for intraabdominal infection

Robert G. Sawyer, Jeffrey A. Claridge, Avery B. Nathens, Ori D. Rotstein, Therese M. Duane, Heather L. Evans, Charles H. Cook, Patrick J. O'Neill, John E. Mazuski, Reza Askari, Mark A. Wilson, Lena M. Napolitano, Nicholas Namias, Preston R. Miller, E. Patchen Dellinger, Christopher M. Watson, Raul Coimbra, Daniel L. Dent, Stephen F. Lowry, Christine S CocanourMichaela A. West, Kaysie L. Banton, William G. Cheadle, Pamela A. Lipsett, Christopher A. Guidry, Kimberley Popovsky

Research output: Contribution to journalArticle

226 Citations (Scopus)

Abstract

BACKGROUND: The successful treatment of intraabdominal infection requires a combination of anatomical source control and antibiotics. The appropriate duration of antimicrobial therapy remains unclear. METHODS: We 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. RESULTS: Surgical-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

Original languageEnglish (US)
Pages (from-to)1996-2005
Number of pages10
JournalNew England Journal of Medicine
Volume372
Issue number21
DOIs
StatePublished - May 21 2015

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Intraabdominal Infections
Anti-Bacterial Agents
Surgical Wound Infection
Control Groups
Therapeutics
Confidence Intervals
Ileus
Leukocytosis
Fever
Infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Sawyer, R. G., Claridge, J. A., Nathens, A. B., Rotstein, O. D., Duane, T. M., Evans, H. L., ... Popovsky, K. (2015). Trial of short-course antimicrobial therapy for intraabdominal infection. New England Journal of Medicine, 372(21), 1996-2005. https://doi.org/10.1056/NEJMoa1411162

Trial of short-course antimicrobial therapy for intraabdominal infection. / 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.

In: New England Journal of Medicine, Vol. 372, No. 21, 21.05.2015, p. 1996-2005.

Research output: Contribution to journalArticle

Sawyer, RG, Claridge, JA, Nathens, AB, Rotstein, OD, Duane, TM, Evans, HL, Cook, CH, O'Neill, PJ, Mazuski, JE, Askari, R, Wilson, MA, Napolitano, LM, Namias, N, Miller, PR, Dellinger, EP, Watson, CM, Coimbra, R, Dent, DL, Lowry, SF, Cocanour, CS, West, MA, Banton, KL, Cheadle, WG, Lipsett, PA, Guidry, CA & Popovsky, K 2015, 'Trial of short-course antimicrobial therapy for intraabdominal infection', New England Journal of Medicine, vol. 372, no. 21, pp. 1996-2005. https://doi.org/10.1056/NEJMoa1411162
Sawyer RG, Claridge JA, Nathens AB, Rotstein OD, Duane TM, Evans HL et al. Trial of short-course antimicrobial therapy for intraabdominal infection. New England Journal of Medicine. 2015 May 21;372(21):1996-2005. https://doi.org/10.1056/NEJMoa1411162
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. / Trial of short-course antimicrobial therapy for intraabdominal infection. In: New England Journal of Medicine. 2015 ; Vol. 372, No. 21. pp. 1996-2005.
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AU - Claridge, Jeffrey A.

AU - Nathens, Avery B.

AU - Rotstein, Ori D.

AU - Duane, Therese M.

AU - Evans, Heather L.

AU - Cook, Charles H.

AU - O'Neill, Patrick J.

AU - Mazuski, John E.

AU - Askari, Reza

AU - Wilson, Mark A.

AU - Napolitano, Lena M.

AU - Namias, Nicholas

AU - Miller, Preston R.

AU - Dellinger, E. Patchen

AU - Watson, Christopher M.

AU - Coimbra, Raul

AU - Dent, Daniel L.

AU - Lowry, Stephen F.

AU - Cocanour, Christine S

AU - West, Michaela A.

AU - Banton, Kaysie L.

AU - Cheadle, William G.

AU - Lipsett, Pamela A.

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AU - Popovsky, Kimberley

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