Infection最新文献

{"title":"HIV-1 virologic failure in the RESINA cohort: lessons from two decades of real-world data.","authors":"Smaranda Gliga, Micha Böhm, Nadine Lübke, Alexander Killer, Falk Hüttig, Lila Haberl, Jörg Timm, Claudia Müller, Eva Heger, Joachim Büch, Gerd Fätkenheuer, Clara Lehmann, Mark Oette, Martin Hower, Heribert Knechten, Niels Schübel, Stefan Esser, Stephan Schneeweiß, Nazifa Qurishi, Katja Römer, Jürgen K Rockstroh, Rolf Kaiser, Tom Luedde, Björn-Erik Ole Jensen","doi":"10.1007/s15010-025-02713-7","DOIUrl":"10.1007/s15010-025-02713-7","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify virologic failure (VF), identify predictors, characterize resistance patterns at failure, and evaluate time to resuppression in the RESINA cohort.</p><p><strong>Methods: </strong>ART-naïve adults initiating ART in 2001-2024 were followed. VF was defined as at least one HIV-1 RNA > 200 copies/mL after suppression or ≥ 0.5-log₁₀ rebound. Participants were grouped by treatment era (2001-2007, 2008-2013, ≥ 2014), reflecting availability of drug classes. Genotypes at baseline and VF were interpreted using the HIV-GRADE algorithm. Predictors of VF were assessed with logistic regression; time to resuppression (< 50 copies/mL) after first VF with Cox models and Kaplan-Meier plots.</p><p><strong>Results: </strong>Among 5136 participants, 139 (2.7%) had VF; rates declined across eras (4.7%, 2.6%, 1.7%). Independent predictors were injection-drug use (OR 1.74), CD4 < 200/µL (OR 2.32), and ART start in 2001-2007 (OR 1.95); MSM acquisition was protective (OR 0.32). At failure, 36 patients showed resistance, often multiclass (61%); INSTI resistance was rare (n = 5). After first VF, 122/139 cases resuppressed (median 147 days). Male sex predicted faster resuppression (HR 1.81); higher failure VL trended to slower resuppression (HR 0.84 per log₁₀). INSTI-based switches consistently achieved resuppression in descriptive analyses and were not associated with multiclass resistance.</p><p><strong>Conclusion: </strong>VF was uncommon and declined over time, reflecting improved regimen potency and tolerability. Failures were associated with late presentation and IDU, consistent with adherence barriers. Resistance often involved multiple classes, while INSTI resistance remained infrequent. Early, genotype-guided optimization, preferably to INSTI-based therapy, combined with targeted adherence support may improve outcomes.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"817-827"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term immune recovery under continuous antiretroviral therapy (ART) among ART-naive people living with HIV in two cohorts in Germany.","authors":"Uwe Koppe, Kirsten Pörtner, Christian Kollan, Annemarie Pantke, Andrea Sailer, Kerstin Dehmel, Stefan Esser, Björn-Erik Ole Jensen, Jürgen Kurt Rockstroh, Guido Schäfer, Dirk Schürmann, Matthias Stoll, Jan-Christian Wasmuth, Tobias Kurth, Barbara Gunsenheimer-Bartmeyer","doi":"10.1007/s15010-026-02740-y","DOIUrl":"10.1007/s15010-026-02740-y","url":null,"abstract":"<p><strong>Objectives: </strong>Immune recovery among people living with HIV (PWHIV) receiving antiretroviral therapy (ART) is determined analysing CD4 cell counts and the CD4/CD8 ratio. Recovery to ≥ 800 CD4 cells/µl and CD4/CD8 ratio ≥ 1 was associated with favourable outcomes. We investigated immune recovery over 10 years among ART-naive PWHIV on ART.</p><p><strong>Methods: </strong>Data were obtained from two German HIV cohorts, the HIV-1 Seroconverter study and the ClinSurv-HIV study, between 2003 and 2018. We included ART-naïve PWHIV starting with continuous ART and analysed CD4 cell counts and the CD4/CD8 ratio. The time to reaching immune thresholds was investigated using Kaplan-Meier analyses with inverse probability censoring weights.</p><p><strong>Results: </strong>Overall, 8,927 participants were included. At baseline, PWHIV had a median CD4 cell count of 257 (interquartile range [IQR] 124-393) cells/µl and CD4/CD8 ratio of 0.26 (IQR 0.14-0.43). After ten years, median CD4 counts increased to 630 (IQR 474-811) cells/µl and CD4/CD8 ratio to 0.84 (IQR 0.61-1.11). PWHIV with higher baseline CD4 values and without viral failure had higher median CD4 counts and CD4/CD8 ratios. The cumulative probability of achieving a CD4 count ≥ 800 cells/µl and/or CD4/CD8 ratio ≥ 1 over 10 years of ART were 54% for the CD4 threshold, 53% for the CD4/CD8 ratio threshold, and 32% for both thresholds. CD4 at baseline was identified as a predictor to achieve immune recovery in all models.</p><p><strong>Conclusions: </strong>Early diagnosis and treatment, as well as effective antiviral therapy without viral failure, should be considered to achieve long-term immune recovery among PWHIV.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"959-970"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147305425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic carriers and multidrug resistance in typhoid fever: pathogenesis, challenges, and integrated control strategies.","authors":"Deepak Kumar, Sudhir Kumar Singh, Gopal Nath","doi":"10.1007/s15010-025-02703-9","DOIUrl":"10.1007/s15010-025-02703-9","url":null,"abstract":"<p><p>Typhoid fever, a systemic disease caused by Salmonella enterica serovar Typhi (S. Typhi), remains a major global health problem, particularly in regions with poor sanitation. Despite advancements in diagnostics and treatment, S. Typhi continues to impose a heavy disease burden, worsened by the emergence of multidrug-resistant (MDR) strains. Chronic carriers, accounting for 2-5% of infections, play a crucial role in disease transmission. These carriers are often asymptomatic but intermittently shed bacteria, sustaining S. Typhi within the human population. Gallstones are strongly associated with the chronic carrier state, providing a niche for bacterial biofilm formation that enhances persistence and antibiotic resistance. Furthermore, long-term colonisation of the gallbladder is linked to an increased risk of gallbladder cancer, a condition common in typhoid-endemic areas. The pathogenesis of typhoid fever involves bacterial invasion of the gastrointestinal mucosa, evasion of innate immunity, and systemic spread. Biofilm formation on gallstones promotes long-term persistence within the gallbladder, while immune responses and intestinal microbiota dynamics influence disease progression and bacterial shedding. Current diagnostic methods, including culture and serology, often fall short in identifying carriers, necessitating the development of innovative approaches for effective surveillance and control. Treating chronic carriers remains difficult due to the biofilm-associated resistance of S. Typhi. Although cholecystectomy combined with targeted antimicrobial therapy shows promise, it does not guarantee the elimination of the carrier state. This review emphasises the importance of integrating strategies that combine improved diagnostic tools, targeted therapies, and public health interventions to reduce the burden of typhoid fever and its chronic carriers.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"619-636"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dismantling infectious disease infrastructure: an analysis of national institute of allergy and infectious diseases grant terminations in 2025.","authors":"Christopher W Chan, Aakash Reddy, Rogelio Perez, David T Zhu","doi":"10.1007/s15010-025-02715-5","DOIUrl":"10.1007/s15010-025-02715-5","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1011-1013"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogen distribution and antimicrobial resistance in simple and complicated urinary tract infections in pediatric patients.","authors":"Elad Libo, Tal Weiss, Ilan Youngster, Amos Adler, Galia Grisaru-Soen","doi":"10.1007/s15010-025-02704-8","DOIUrl":"10.1007/s15010-025-02704-8","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"761-770"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linezolid versus clindamycin for toxin inhibition in severe skin and soft tissue infections: a systematic review and meta-analysis.","authors":"Ashton Stropes, Caleb Lautenschlager, Andrew Smith, Taylor D Steuber, Morgan Sperry","doi":"10.1007/s15010-025-02722-6","DOIUrl":"10.1007/s15010-025-02722-6","url":null,"abstract":"<p><strong>Purpose: </strong>Necrotizing soft tissue infections (NSTIs) are life-threatening infections often caused by toxin-producing bacteria. Clindamycin has historically been favoured for its toxin-inhibiting properties but increasing resistance and adverse effects have prompted interest in alternatives. This study evaluates the efficacy and safety of linezolid versus clindamycin plus anti-gram-positive therapy in patients with severe or necrotizing skin and soft tissue infections (SSTIs).</p><p><strong>Methods: </strong>A systematic literature search through December 12, 2024, was conducted across eight databases and clinical trial registries. Studies comparing linezolid-containing regimens to clindamycin plus anti-gram-positive therapy in patients with severe SSTIs were included. Outcomes of interest included ICU length of stay (LOS), hospital LOS, mortality, ventilator days, vasopressor days, antimicrobial duration, and adverse effects. Random-effects meta-analyses were performed for ICU LOS and hospital LOS.</p><p><strong>Results: </strong>Of 310 articles screened, four retrospective studies met inclusion criteria. Moderate to significant risk of bias was present. No significant differences were observed in ICU LOS (mean difference [MD]: -0.001 days; 95% CI: -1.110 to 1.107; p = 0.998; I² = 0.8%) or hospital LOS (MD: -2.797 days; 95% CI: -7.027 to 1.433; p = 0.195). Two studies reported lower rates of acute kidney injury (AKI) with linezolid. Mortality data were limited. No other significant differences were found.</p><p><strong>Conclusions: </strong>No significant difference in ICU and hospital length of stay were noted between linezolid and clindamycin-based regimens. Lower rates of AKI were reported with linezolid. However, given the study design and potential risk of bias these results should be interpreted with caution.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"877-885"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoptysis in a patient with MDR-tuberculosis: successful diagnosis with photon counting CT and embolization of a Rasmussen aneurysm.","authors":"Lukas van de Sand, Benedikt M Schaarschmidt, Johannes Wienker, Oliver Witzke, Markus Zettler","doi":"10.1007/s15010-025-02660-3","DOIUrl":"10.1007/s15010-025-02660-3","url":null,"abstract":"<p><strong>Background: </strong>Multidrug-resistant tuberculosis (MDR-TB) remains a significant clinical challenge and may be complicated by life-threatening hemoptysis. One rare but serious cause of hemoptysis in TB patients is the development of pulmonary artery pseudoaneurysms, known as Rasmussen aneurysms, which typically arise within or adjacent to tuberculous cavitary lesions.</p><p><strong>Case presentation: </strong>We report the case of a 57-year-old male patient who was diagnosed with MDR-TB in July 2024, confirmed by phenotypic resistance against rifampicin and isoniazid. According to WHO recommendations treatment with the BPaLM regimen (bedaquiline, pretomanid, linezolid, and moxifloxacin) was initiated in early August 2024 and was administered according to an extended 9-month schedule due to clinical considerations. After approximately seven months of therapy, the patient was re-hospitalized in March 2025 due to hemoptysis. A thoracic photon counting CT scan revealed regressing bilateral cavitary lesions. During the same month, a pseudoaneurysm arising from a subsegmental pulmonary artery within a cavity-consistent with a Rasmussen aneurysm-was identified. Successful embolization of the feeding vessel was performed under angiographic guidance. Post-interventional bronchoscopy showed minimal residual bloody secretions at the embolization site but no evidence of active bleeding after thorough irrigation. At that time, pending cultures for M. tuberculosis finally converted negative. The patient recovered well, and no further hemoptysis occurred.</p><p><strong>Conclusions: </strong>This case highlights the importance of considering Rasmussen aneurysms as a potential cause of hemoptysis in patients with cavitary MDR-TB, even several months after starting antibiotic therapy. Prompt imaging-based diagnosis and endovascular intervention are critical to avoid life-threatening complications.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"983-989"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of resistance to novel β-lactam/β-lactamase inhibitor combinations in KPC-producing Klebsiella pneumoniae: clinical and genomic insights from consecutive bloodstream infections.","authors":"Matteo Boattini, Sara Comini, Guido Ricciardelli, Lisa Pastrone, Roberto Casale, Luisa Guarrasi, Rossana Cavallo, Cristina Costa, Paolo Gaibani, Gabriele Bianco","doi":"10.1007/s15010-025-02716-4","DOIUrl":"10.1007/s15010-025-02716-4","url":null,"abstract":"<p><strong>Purpose: </strong>Novel β-lactam/β-lactamase inhibitor combinations (BL/BLICs) such as ceftazidime/avibactam (CAZ/AVI), meropenem/vaborbactam (MEM/VAB), imipenem/relebactam (IMP/REL) and aztreonam/avibactam (ATM/AVI) have expanded therapeutic choices against KPC-producing K. pneumoniae. However, emerging resistance threatens their long-term efficacy. We investigated the prevalence, genomic mechanisms, and clinical correlates of resistance to these agents among KPC-producing K. pneumoniae bloodstream isolates.</p><p><strong>Methods: </strong>Consecutive KPC-producing K. pneumoniae bloodstream isolates collected between 2021 and 2024 at a tertiary university hospital were tested for susceptibility to novel BL/BLICs and comparators. Whole-genome sequencing (WGS) was performed on isolates resistant to any BL/BLIC to characterise genetic backgrounds. Clinical data from corresponding patients were analysed to explore risk factors and outcomes.</p><p><strong>Results: </strong>Among 178 K. pneumoniae isolates, ATM/AVI, IMP/REL and MEM/VAB retained excellent in vitro activity (≥ 96% susceptible), while 11% were resistant to CAZ/AVI. One hundred fifty-four (86.5%) were susceptible to all BL/BLICs, whereas 24 (13.5%) displayed resistance to at least one agent, most commonly CAZ/AVI. WGS revealed a genetically diverse population mainly comprising high-risk clones ST512 and ST101. Resistance was driven by KPC variants (KPC-31, KPC-167, KPC-93, KPC-49, KPC-14, KPC-121, KPC-33) and porin disruptions (OmpK36 insertions, OmpK35 loss). Most patients (91%) had prior colonisation and recent β-lactam exposure; median time to resistance emergence was 47 days. The 28-day mortality among patients with BL/BLIC-resistant infections was 21.7%.</p><p><strong>Conclusion: </strong>Resistance to novel BL/BLICs among KPC-producing K. pneumoniae is emerging in Italian hospitals, largely mediated by bla_KPC variants and porin defects under selective antibiotic pressure. While ATM/AVI, MEM/VAB and IMP/REL remain highly active, resistance to CAZ/AVI is increasingly frequent. Continuous genomic surveillance and optimised antimicrobial stewardship are essential to preserve the efficacy of these last-line agents.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"841-852"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex disparities in tuberculosis outcomes: evidence from a multicenter Italian cohort (Italian South TB Network (ISTB-Net).","authors":"Francesco Di Gennaro, Alessandro Cornelli, Giacomo Guido, Rosa Buonamassa, Francesco Cavallin, Mariantonietta Pisaturo, Lorenzo Onorato, Federica Zimmerhofer, Giuseppe Bruno, Massimo Fasano, Agostina Pontarelli, Tiziana Iacovazzi, Luisa Frallonardo, Gianfranco Panico, Raffaella Libertone, Caterina Monari, Alessia Musto, Francesca Serapide, Mariangela Niglio, Sergio Cotugno, Roberta Papagni, Alberto Enrico Maraolo, Loredana Alessio, Giulio Viceconte, Giuseppina De Iaco, Aurelia Ricciardi, Rossana Lattanzio, Federica De Gregorio, Helen Linda Morrone, Ylenia Farinaccio, Gaetano Brindicci, Marinella Cibelli, Carmen Pellegrino, Giorgia Manco Cesari, Vito Spada, Paolo Tundo, Paola Mencarini, Carmen Rita Santoro, Giuliana Metrangolo, Annamaria Maci, Grazia Pietramatera, Gina Gualano, Salvatore Minniti, Giovanni Battista Buccoliero, Sergio Lo Caputo, Alessandra Prozzo, Sergio Carbonara, Antonio Cascio, Alessandro Russo, Ivan Gentile, Roberto Parrella, Fabrizio Palmieri, Nicola Coppola, Annalisa Saracino","doi":"10.1007/s15010-026-02725-x","DOIUrl":"10.1007/s15010-026-02725-x","url":null,"abstract":"<p><strong>Background: </strong>Sex disparities in tuberculosis (TB) outcomes are not well characterized, especially in high-income countries where social vulnerability and migration influence access to care. Although men globally experience a higher TB burden, the interaction between sex, migration, and social determinants is complex and extends beyond biological factors. This study evaluated sex differences in clinical and programmatic TB outcomes in a high-income European country with a significant substantial migrant population.</p><p><strong>Methods: </strong>A retrospective multicentre cohort study was conducted across 16 Infectious Diseases Units in seven Italian regions from (January 2021 to September 2025). Outcomes included time to sputum conversion (in pulmonary TB), length of hospital stay (LOS), adverse events (AEs) and their severity, incomplete treatment (defined as failure, death, or loss to follow-up), and loss to follow-up (LTFU). Mixed-effects models were applied using two prespecified adjustment sets: sex, centre, and core confounders (Model A); and sex, centre, and clinically relevant baseline imbalances (Model B). Sub-analyses examined the impact of migration status.</p><p><strong>Results: </strong>Of 982 TB patients, 229 (23.3%) were women and 753 (76.7%) were men. Women exhibited lower rates of smoking (24.4% vs 36.7%), diabetes (7.9% vs 15.8%), and COPD/bronchiectasis (4.5% vs 10.3%). The median sputum conversion time was 21 days for both sexes. Adjusted analysesindicated shorter LOS among women (Model A: - 22% [95%CI - 32 to - 10]; Model B: - 19% [95%CI - 28 to - 9]). Time to sputum conversion was slightly shorter in women in Model A (- 13%; 95%CI -23% to -1%) but not in Model B (- 9%; 95%CI -17% to 1%). The risk and severity of AEs were similar between sexes. In Model B, women had lower odds of incomplete treatment (OR 0.64 [95%CI 0.41 to 0.99]) and LTFU (OR 0.62 [95%CI 0.38 to 0.99]). Migrants experienced worse overall outcomes, but the effect of sex did not differ by migration status.</p><p><strong>Conclusion: </strong>Women had consistently shorter hospital stays and greater treatment continuity without increased toxicity, indicating that sex differences in TB outcomes are likely attributable to social and behavioural factors rather than biological differences. Supportive associative networks and non-governmental organisations may help reduce sex disparities, underscoring the importance of sex- and migration-responsive TB care models in Europe.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"895-903"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is short-course antibiotic therapy as safe and effective as long-course therapy after surgery for complicated appendicitis? A systematic review and meta-analysis.","authors":"Kai Lu, Shilong Shu, Xuefeng Peng, Faqiang Zhang, Yong Cheng, Hua Yang","doi":"10.1007/s15010-025-02693-8","DOIUrl":"10.1007/s15010-025-02693-8","url":null,"abstract":"<p><strong>Background: </strong>Short-course antibiotic (SCA) therapy after appendectomy for complicated appendicitis (CA) has gained increasing attention, but its safety and efficacy remain insufficiently supported by meta-analyses. This study aimed to evaluate whether SCA therapy is as safe and effective as conventional long-course antibiotic (LCA) therapy following appendectomy for CA.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted to identify randomized controlled trials (RCTs) and observational studies comparing different durations of postoperative antibiotic therapy for CA. Data were analyzed using RevMan 5.3 for meta-analysis, and the GRADE approach was applied to assess the quality of evidence for key outcomes.</p><p><strong>Results: </strong>Four RCTs and nine observational studies involving 3,251 patients were included. The meta-analysis revealed no significant increase in the risk of surgical site infection (SSI) (RR = 1.19, 95% CI: 0.52 to 2.73, P = 0.67, low-quality evidence) or intra-abdominal abscess (IAA) (RR = 1.18, 95% CI: 0.92 to 1.51, P = 0.19, moderate-quality evidence) with less than 3-day SCA therapy compared to LCA therapy. Secondary outcomes showed no significant differences between the two regimens (moderate to very-low quality evidence). However, SCA therapy was associated with a shorter length of hospital stay (low-quality evidence).</p><p><strong>Conclusion: </strong>For patients with CA, less than 3-day SCA therapy does not increase the risk of SSI or IAA. Moreover, reducing the duration of antibiotic use may help minimize unnecessary antibiotic consumption.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"607-618"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}