Long-term suppressive 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.
Baddour
L M
LM
Department of Medicine, Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, 37920-6999, USA. lbaddour@mc.utmck.edu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects; D016459:Prosthesis-Related Infections / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors
D000890:Anti-Infective Agents