1469. Effect of Treatment Duration on Outcomes in Septic Patients Admitted for Urinary Tract Infections from Extended Care Facilities

Abstract

BackgroundAdults in extended care facilities (ECFs) are at an increased risk of urinary tract infections (UTIs) with sepsis and there are little data on effective antibiotic duration. The purpose of this project was to assess the impact of inpatient antibiotic duration on clinical outcomes in these patients.MethodsA single-center, retrospective study of adult, ECF, septic UTI patients from 5/1/16 to 4/30/18 were included. In-hospital mortality, 30-day readmission rate, and length-of-stay (LOS) were compared based on the effective antibiotic duration of short- and long-term therapies (≤ 5 and > 5 days, respectively). Pregnant and asymptomatic bacteriuria patients were excluded. Demographics, Charlson Weighted Index of Comorbidity (CWIC), presence of indwelling catheter, SIRS criteria, microbiologic results and antibiotic regimen were collected. Continuous variables were analyzed using Student’s t-test and categorical variables with Chi-square test.Results105 of 1,158 ECF patients met the inclusion criteria. 38 patients received ≤ 5 days of effective antibiotic therapy, and 67 received > 5 days. Baseline demographics were similar, except the ≤ 5 days group were older and less likely to have fever (see table). In-hospital mortality was 18.4% in the short-term antibiotic group and 6.0% in the long-term group. Overall 30-day readmission was not significantly different. LOS was significantly greater in the > 5 day overall and non-bacteremia group.ConclusionDuration of antibiotics (≤ 5 and > 5 days) did not significantly affect 30-day readmission and in-hospital mortality; however, LOS was significantly longer in the > 5 days group. Further studies are needed to confirm these findings. Disclosures All authors: No reported disclosures.