Effects of extended anaerobic antibiotic coverage on anaerobic bloodstream infection: A multisite retrospective study
Objectives: Routine clinical practice with extended anaerobic antibiotic coverage (EAC) has been recently reconsidered for several infections; however, its benefits remain unclear even in patients with anaerobic bacteremia (AB). Here, we aimed to elucidate the effects of EAC on AB prognosis. Methods...
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Elsevier
2025-04-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225000633 |
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| author | Yushi Murai Kentaro Nagaoka Naoki Iwanaga Hitoshi Kawasuji Masayoshi Miura Yukihiro Sato Yukihiro Hatakeyama Yukari Kato Takahiro Takazono Kosuke Kosai Aki Sugano Yoshitomo Morinaga Kaori Tanaka Katsunori Yanagihara Hiroshi Mukae Yoshihiro Yamamoto |
| author_facet | Yushi Murai Kentaro Nagaoka Naoki Iwanaga Hitoshi Kawasuji Masayoshi Miura Yukihiro Sato Yukihiro Hatakeyama Yukari Kato Takahiro Takazono Kosuke Kosai Aki Sugano Yoshitomo Morinaga Kaori Tanaka Katsunori Yanagihara Hiroshi Mukae Yoshihiro Yamamoto |
| author_sort | Yushi Murai |
| collection | DOAJ |
| description | Objectives: Routine clinical practice with extended anaerobic antibiotic coverage (EAC) has been recently reconsidered for several infections; however, its benefits remain unclear even in patients with anaerobic bacteremia (AB). Here, we aimed to elucidate the effects of EAC on AB prognosis. Methods: A multicenter retrospective observational study was conducted in patients with AB. Multivariate logistic regression analysis was performed to assess the effect of EAC on 30-day mortality. Inverse probability of treatment weighting analysis was performed to confirm the robustness of the findings. Results: In total, 483 patients were included, of whom 387 received EAC and 96 received limited anaerobic antibiotic coverage (LAC). Atypical foci of anaerobic infection, such as urinary tract infection and pneumonia, together with undetectable infection foci, comprised a larger proportion of infection foci in the LAC group than that in the EAC group (46.9% vs 30.5%). The 30-day mortality rates of the EAC and LAC groups were similar (12.5% and 14.2%, respectively; P = 0.664). Primary analysis revealed that EAC was not significantly associated with high mortality (odds ratio [OR], 1.42; 95% confidence interval [CI], 0.7-2.8), whereas source control significantly reduced this risk (OR, 0.28; 95% CI, 0.2-0.5). The sensitivity analysis results were consistent with those of the primary analyses. Conclusion: This study demonstrated a less significant effect of initial EAC on AB compared with source control, particularly on AB with atypical infection foci. These findings would prompt reconsideration of the necessity of an initial EAC in several infections. |
| format | Article |
| id | doaj-art-035b5cae949e4a34a10f207fc0a51f39 |
| institution | DOAJ |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-035b5cae949e4a34a10f207fc0a51f392025-08-20T03:16:25ZengElsevierInternational Journal of Infectious Diseases1201-97122025-04-0115310784010.1016/j.ijid.2025.107840Effects of extended anaerobic antibiotic coverage on anaerobic bloodstream infection: A multisite retrospective studyYushi Murai0Kentaro Nagaoka1Naoki Iwanaga2Hitoshi Kawasuji3Masayoshi Miura4Yukihiro Sato5Yukihiro Hatakeyama6Yukari Kato7Takahiro Takazono8Kosuke Kosai9Aki Sugano10Yoshitomo Morinaga11Kaori Tanaka12Katsunori Yanagihara13Hiroshi Mukae14Yoshihiro Yamamoto15Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Corresponding author: Kentaro Nagaoka, Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan.Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, JapanDepartment of Infection Control, Toyama Nishi General Hospital, Toyama, JapanDepartment of Infection Control, Kamiichi General Hospital, Toyama, JapanDepartment of Infection Control, Takaoka City Hospital, Toyama, JapanDepartment of Infection Control, Toyama City Hospital, Toyama, JapanDepartment of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, JapanDepartment of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, JapanCenter for Clinical Research, Toyama University Hospital, Toyama, JapanDepartment of Microbiology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, JapanDivision of Anaerobe Research, Life Science Research Center, Gifu University, Gifu, JapanDepartment of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, JapanDepartment of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, JapanObjectives: Routine clinical practice with extended anaerobic antibiotic coverage (EAC) has been recently reconsidered for several infections; however, its benefits remain unclear even in patients with anaerobic bacteremia (AB). Here, we aimed to elucidate the effects of EAC on AB prognosis. Methods: A multicenter retrospective observational study was conducted in patients with AB. Multivariate logistic regression analysis was performed to assess the effect of EAC on 30-day mortality. Inverse probability of treatment weighting analysis was performed to confirm the robustness of the findings. Results: In total, 483 patients were included, of whom 387 received EAC and 96 received limited anaerobic antibiotic coverage (LAC). Atypical foci of anaerobic infection, such as urinary tract infection and pneumonia, together with undetectable infection foci, comprised a larger proportion of infection foci in the LAC group than that in the EAC group (46.9% vs 30.5%). The 30-day mortality rates of the EAC and LAC groups were similar (12.5% and 14.2%, respectively; P = 0.664). Primary analysis revealed that EAC was not significantly associated with high mortality (odds ratio [OR], 1.42; 95% confidence interval [CI], 0.7-2.8), whereas source control significantly reduced this risk (OR, 0.28; 95% CI, 0.2-0.5). The sensitivity analysis results were consistent with those of the primary analyses. Conclusion: This study demonstrated a less significant effect of initial EAC on AB compared with source control, particularly on AB with atypical infection foci. These findings would prompt reconsideration of the necessity of an initial EAC in several infections.http://www.sciencedirect.com/science/article/pii/S1201971225000633Anaerobic bacteremiaAnaerobic coverageAnaerobic spectrumAbscess lesionsSource control |
| spellingShingle | Yushi Murai Kentaro Nagaoka Naoki Iwanaga Hitoshi Kawasuji Masayoshi Miura Yukihiro Sato Yukihiro Hatakeyama Yukari Kato Takahiro Takazono Kosuke Kosai Aki Sugano Yoshitomo Morinaga Kaori Tanaka Katsunori Yanagihara Hiroshi Mukae Yoshihiro Yamamoto Effects of extended anaerobic antibiotic coverage on anaerobic bloodstream infection: A multisite retrospective study International Journal of Infectious Diseases Anaerobic bacteremia Anaerobic coverage Anaerobic spectrum Abscess lesions Source control |
| title | Effects of extended anaerobic antibiotic coverage on anaerobic bloodstream infection: A multisite retrospective study |
| title_full | Effects of extended anaerobic antibiotic coverage on anaerobic bloodstream infection: A multisite retrospective study |
| title_fullStr | Effects of extended anaerobic antibiotic coverage on anaerobic bloodstream infection: A multisite retrospective study |
| title_full_unstemmed | Effects of extended anaerobic antibiotic coverage on anaerobic bloodstream infection: A multisite retrospective study |
| title_short | Effects of extended anaerobic antibiotic coverage on anaerobic bloodstream infection: A multisite retrospective study |
| title_sort | effects of extended anaerobic antibiotic coverage on anaerobic bloodstream infection a multisite retrospective study |
| topic | Anaerobic bacteremia Anaerobic coverage Anaerobic spectrum Abscess lesions Source control |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225000633 |
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