Carmen Cabellos1, Ivan Pelegrín2, Eva Benavent3, Francesc Gudiol3, Fe Tubau4, Dolores Garcia-Somoza4, Ricard Verdaguer4, Javier Ariza3, Pedro Fernandez-Viladrich3. 1. Infectious Diseases Department, IDIBELL-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain. Electronic address: ccabellos@bellvitgehospital.cat. 2. Infectious Diseases Department, IDIBELL-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain. Electronic address: ivan_pelegrin@hotmail.com. 3. Infectious Diseases Department, IDIBELL-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain. 4. Microbiology Department, IDIBELL-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
Abstract
BACKGROUND: Invasive meningococcal disease is a severe infection. The appropriate duration of antibiotic therapy is not well established. METHODS: Two hundred and sixty-three consecutive patients with invasive meningococcal disease treated with 4 days' antibiotic therapy were compared with 264 consecutive patients treated previously at the same center with 7 days' antibiotic therapy. A Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR) study was also performed. RESULTS: No relapses were recorded in any patient. Patients on the 4-day course were 63% female, with a median age of 23 years old (IQR 16-54) and patients on the 7-day course were 61% female, with a median age of 17 years old (IQR 12-43). Case fatality rate was 7% in the 4-d patients and 6% in the 7-d patients (p = 0.582). Neurological sequelae were recorded in 6% of the 4-d group and in 7% of the 7-d group ((p = 0.509) and cutaneous sequelae in 3% in both groups. There were no statistical significant differences between the groups in terms of clinical characteristics, laboratory findings or complications. The probability that a patient had a randomly chosen DOOR better with the 4-day regimen than with the 7-day regimen was 80.4% [95% CI 80.1-80.7%]. CONCLUSION: Invasive meningococcal disease may be successfully treated with a four-day course of antibiotic therapy without relapses.
BACKGROUND:Invasive meningococcal disease is a severe infection. The appropriate duration of antibiotic therapy is not well established. METHODS: Two hundred and sixty-three consecutive patients with invasive meningococcal disease treated with 4 days' antibiotic therapy were compared with 264 consecutive patients treated previously at the same center with 7 days' antibiotic therapy. A Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR) study was also performed. RESULTS: No relapses were recorded in any patient. Patients on the 4-day course were 63% female, with a median age of 23 years old (IQR 16-54) and patients on the 7-day course were 61% female, with a median age of 17 years old (IQR 12-43). Case fatality rate was 7% in the 4-d patients and 6% in the 7-d patients (p = 0.582). Neurological sequelae were recorded in 6% of the 4-d group and in 7% of the 7-d group ((p = 0.509) and cutaneous sequelae in 3% in both groups. There were no statistical significant differences between the groups in terms of clinical characteristics, laboratory findings or complications. The probability that a patient had a randomly chosen DOOR better with the 4-day regimen than with the 7-day regimen was 80.4% [95% CI 80.1-80.7%]. CONCLUSION:Invasive meningococcal disease may be successfully treated with a four-day course of antibiotic therapy without relapses.
Authors: Matthew Broom; Emma Best; Helen Heffernan; Sara Svensson; Maria Hansen Hygstedt; Rachel Webb; Nick Gow; David Holland; Mark Thomas; Simon Briggs Journal: Infection Date: 2022-08-18 Impact factor: 7.455
Authors: Carmen Cabellos; Ivan Pelegrín; Eva Benavent; Francesc Gudiol; Fe Tubau; Dolores Garcia-Somoza; Ricard Verdaguer; Javier Ariza; Pedro Fernandez Viladrich Journal: Open Forum Infect Dis Date: 2019-02-07 Impact factor: 3.835