ArticleAnnals of clinical microbiology and antimicrobials2025
Antibiotic stewardship in hematological patients with Escherichia coli and Klebsiella pneumoniae bloodstream infections: evaluating short-course and carbapenem-sparing strategies.
Article in Annals of clinical microbiology and antimicrobials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Carbapenem-Sparing Antimicrobial Stewardship in Internal Medicine: A Prospective Quasi-Experimental Before-and-After Pilot Implementation Study.Antibiotics (Basel, Switzerland) · 2026Article
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17 authors.
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Abstract
backgroundTo address the overuse of antibiotics, this study examined the clinical characteristics and outcomes associated with antibiotic duration and carbapenem-sparing regimens in hematological patients with Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bloodstream infections (BSI).
methodsWe conducted a retrospective analysis of hematological patients with E. coli or K. pneumoniae BSI from 2017 to 2023. Propensity score matching (PSM) controlled for confounding variables, and data were analyzed using multivariate regression models.
resultsA total of 1,862 patients were included (E. coli: n = 932; K. pneumoniae: n = 930). Among 1,105 patients in the antibiotic duration cohort, 48.96% (n = 541) received short-course therapy (median: 8 days, IQR: 7-9), while others received prolonged-course therapy (median: 14 days, IQR: 12-17). No significant differences in 30-day mortality or 90-day recurrence rates were observed between the two groups, either before or after PSM. In the antibiotic regimen cohort (n = 1,606), we assessed the effectiveness of carbapenem-containing versus carbapenem-sparing regimens, as well as monotherapy versus combination therapy. Among 1,488 patients with non-carbapenem-resistant Enterobacteriaceae (non-CRE) infections, 567 had infections caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria. In this subgroup, 30-day mortality rates also showed no significant differences between carbapenem-containing and carbapenem-sparing regimens, both before and after PSM.
conclusionIn conclusion, short-course antibiotic therapy is as effective as prolonged therapy for treating E. coli and K. pneumoniae BSI in hematological patients. Similarly, carbapenem-sparing regimens are non-inferior to carbapenem-based regimens. These findings highlight the potential for optimizing antibiotic use, but further validation through randomized controlled trials is warranted.
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