Long-term suppressive for antimicrobial therapy for intravascular device-related infections

Background. Long-term suppressive antimicrobial therapy is an alternative treatment choice in patients with medical device-related infection who are not eligible for surgical device removal for attempted cure. There is a paucity of data published that examines this treatment option. Methods: Members of the Infectious Diseases Society of America's Emerging Infections Network were polled to identify patients with intravascular device-related infections who were not candidates for surgery and were given long-term antimicrobial therapy to suppress clinical manifestations of infection. Results: Clinical and microbiologic data were collected retrospectively for 51 patients. Sixty-nine percent of patients were men; vascular grafts were the most common type of medical device infected [30 (58.8%) patients]. Sixty-three percent (32 of 51) of cases involved Gram-positive cocci. A variety of antimicrobials were administered as chronic suppressive therapy, with beta -lactams used most frequently (39.2%). Therapy ranged from 3 months to 10 years. Three (7.32%) of 41 patients in whom follow-up data were available developed relapsing infection while on long-term suppressive therapy. Three other patients suffered drug adverse events. Conclusions: Overall, long-term suppressive therapy was well-tolerated and efficacious in preventing signs of infection relapse.