Impact of the presence of a prosthetic implant and transition to oral stepdown therapy on relapse rates and mortality in uncomplicated Staphylococcus aureus bacteremia treated with 14 days of antibiotics: a retrospective cohort study

• Published in: Microbiology spectrum Vol. 13; no. 7; p. e0333724
• Main Authors: Blez, Damien, Labarbe, Luc, Grohs, Patrick, Mainardi, Jean-Luc, Barnier, Jean-Philippe, Lebeaux, David, Dubert, Marie
• Format: Journal Article
• Language: English
• Published: United States American Society for Microbiology 01.07.2025
• Subjects: Administration, Oral; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Antimicrobial Chemotherapy; Bacteremia - drug therapy; Bacteremia - microbiology; Bacteremia - mortality; device; Female; Humans; Male; Middle Aged; oral stepdown therapy; Prostheses and Implants - microbiology; prosthesis; Prosthesis-Related Infections - drug therapy; Prosthesis-Related Infections - mortality; Recurrence; Research Article; Retrospective Studies; short-course antibiotic therapy; Staphylococcal Infections - drug therapy; Staphylococcal Infections - microbiology; Staphylococcal Infections - mortality; Staphylococcus aureus - drug effects; Staphylocococcus aureus; Treatment Outcome; device; oral stepdown therapy; prosthesis; short-course antibiotic therapy; Staphylocococcus aureus
• ISSN: 2165-0497; 2165-0497
• DOI: 10.1128/spectrum.03337-24

This retrospective study provides reassuring real-world data supporting a short 14-day treatment course for SAB in patients with PIs. In an era of increasing antimicrobial resistance worldwide, these retrospective findings support the perspective that not all PIs are systematically infected. Prolonged antibiotic therapy may therefore not be routinely needed if infection is excluded and thorough evaluation for dissemination performed, accompanied by close clinical and biological monitoring. Early transition to oral therapy in this context, which has been implemented in our institution for years, does not appear to be associated with a higher risk of therapeutic failure. These findings align with the most recent literature on the subject.