2025 Southeastern Residency Conference

Title: Differences in Duration of Treatment for Extended-Spectrum Beta-Lactamase (ESBL) Infections 


Authors: Natalee Chornak, Jen Tharp, Cameron Lanier, Edward Grace, David Cluck


Objective: Assess for differences in duration of treatment of ESBL infections from a urinary source


Self Assessment Question: In Progress


Background: With nearly 3 million cases of antimicrobial resistant infections in the United States per year, antimicrobial resistance has and continues to be a major public health threat, both nation and worldwide. Current Infectious Disease Society of America (IDSA) guidelines do not recommend different treatment durations for infections based on phenotypic resistance. The purpose of this study is to compare treatment of ESBL and non-ESBL infections from a urinary source and assess differences in treatment duration.


Methods: This study is a retrospective cohort study being conducted within 18 Ballad Health facilities between June 1, 2021 – June 30, 2024. Inclusion criteria consist of patients who are 18 years old or greater who had positive urine cultures for Escherichia coli or Klebsiella pneumoniae and received inpatient antibiotics for at least 24 hours. Exclusion criteria include patients who are pregnant, incarcerated, require use of a catheter, have urological abnormalities, conditions with inadequate source control, have a polymicrobial infection, have an indication for prolonged antibiotic treatment independent of current infection, or require Intensive Care Unit (ICU) level of care. Patients will be divided into two cohorts; those with urinary tract infection (UTI) only and those with bacteremia from a urinary source. The primary endpoint is a difference in duration of treatment of ESBL and non-ESBL organisms from a urinary source. Secondary endpoints include duration of antibiotic use, duration of treatment without a susceptible agent, hospital length of stay, readmission within 90-days, re-infection by the same organism within 90-days, and incidence of Infectious Disease consults placed.


Results: In Progress


Conclusion: In Progress