期刊
JOURNAL OF NUCLEAR MEDICINE
卷 60, 期 7, 页码 998-1002出版社
SOC NUCLEAR MEDICINE INC
DOI: 10.2967/jnumed.118.221929
关键词
F-18-FDG PET/CT; Staphylococcus aureus; metastatic infection; treatment duration
Current guidelines recommend intravenous antibiotic therapy for at least 4 wk in patients with high-risk Staphylococcus aureus bacteremia (SAB), because of the risk for metastatic infection. We evaluated the safety of a shorter duration of treatment in patients with high-risk SAB without signs of metastatic infection at presentation, using standard F-18-FDG PET/CT and echocardiography. Methods: Retrospective analyses were performed of patients with SAB admitted between 2013 and 2017 in 2 medical centers. Patients with risk factors for complicated bacteremia (community acquisition, persistently positive blood cultures, >72 h of fever, or foreign body materials present), a normal echocardiography result, and F-18-FDG PET/CT without signs of metastatic infection were included (cases) and compared with patients with uncomplicated bacteremia (absence of any of the risk factors and no known metastatic disease, controls). Primary outcomes were 3-mo SAB-specific mortality rate and recurrent infection. The secondary outcome was overall mortality. Results: We included 36 cases and 40 controls. Both groups had a similar treatment duration (15.9 vs. 15.4 d). No deaths occurred as a consequence of SAB in the cases, compared with 1 in the control group. One relapse occurred in the case group and 2 in the control group. Overall mortality did not differ between the groups (19.4% vs. 15.0%, P = 0.64). Conclusion: This study suggests that intravenous treatment for 2 wk in high-risk patients with SAB without endocarditis and absence of metastatic infection on F-18-FDG PET/CT is safe. A diagnostic-driven approach using F-18-FDG PET/CT to determine treatment duration in high-risk SAB seems feasible and allows tailoring treatment to individual patients.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据