ANTIBIOTIC THERAPY DURATION IN COMPLICATED PLEURAL INFECTION AND EMPYEMA

Abstract

SESSION TITLE: Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Optimizing the duration of antibiotics is a key component of antibiotic stewardship. Pleural infection is a common disease with an increasing incidence and associated with high mortality and poor clinical outcome. It is estimated that around 20% of patients with empyema die and approximately 20% require surgery. There is paucity of data regarding optimal antibiotic duration in complicated pleural infection. We evaluated the impact of antibiotic duration in pleural infection. METHODS: An observational database of patients with pleural infection in a tertiary care center was utilized. A non-parsimonious propensity model based on demographic variables, prognostic factors such as Charlson Comorbidity Index and mortality score (RAPID) was used to identify matched cohorts who received ≤ 4 weeks and > 4 weeks of antibiotics. Analyses used matched patients with the nearest propensity score. RESULTS: A total of 589 patients were admitted with complicated pleural infection between 2008 until 2019. After the propensity score matching, a total of 268 patients (134 in each group) were available for analyses. Median antibiotic duration was 20.00 (IQR 14.00-22.00) for ≤4 weeks group and 44.00 (34-59) for > 4 weeks group after the propensity score matching (p<0.001). Intravenous antibiotic duration was 13.00 (IQR 8.00-19.75) and 37.00 (25.25-48.00) days for each group. The propensity score-matched analysis showed that the overall mortality, specific mortality due to pleural infection and treatment failure was not significant between groups (OR 0.66, p=0.16; OR 0.78, p=0.55; OR 0.80, p=0.99), respectively. CONCLUSIONS: Our findings demonstrate that a shorter antibiotic course is an effective adjunctive therapy for complicated pleural infection and empyema. Further prospective, randomized clinical trials to assess optimal antibiotic duration are needed. CLINICAL IMPLICATIONS: A shorter antibiotic course (less than 4 weeks) is an effective therapy for complicated pleural infection and empyema. DISCLOSURES: No relevant relationships by Ramsy Abdelghani, source=Web Response No relevant relationships by Alvaro Ayala, source=Web Response No relevant relationships by Alex Chee, source=Web Response No relevant relationships by Fayez Kheir, source=Web Response Consultant relationship with Boston Scientific Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with olympus Please note: $5001 - $20000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with pinacle biologics Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with cook medical Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee No relevant relationships by Rachel Martinez, source=Web Response No relevant relationships by Mihir Parikh, source=Web Response No relevant relationships by Priya Patel, source=Web Response No relevant relationships by Alichia Paton, source=Web Response No relevant relationships by Juan Pablo Uribe, source=Web Response