Escherichia coli 혈류감염에서 항생제 전환 양상 분석 : 단일기관 후향적 관찰연구 = Analysis of Antibiotic Transition Patterns in Escherichia coli Bloodstream Infections: A Single-center Retrospective Observational Study

다국어 초록 (Multilingual Abstract)

Background : Bloodstream infections are associated with high mortality rates, making appropriate empirical therapy crucial. However, the overuse of broad-spectrum antibiotics contributes to antibiotic resistance. This study focused on Escherichia coli (E. coli) bloodstream infections to assess antibiotic transitions and support effective de-escalation strategies within the Antimicrobial Stewardship Program (ASP) framework.
Methods : We conducted a retrospective study involving adult patients with monomicrobial E. coli bloodstream infections at a tertiary hospital between January and June 2025. Clinical and microbiological data were analyzed, and antibiotic transitions were assessed based on susceptibility results within 48 hours of reporting.
Results : The study included 46 patients with E. coli bloodstream infections (intervention group, n=21; non-intervention group, n=25). The rate of ESBL (Extended-spectrum β-lactamase)-producing E. coli was sig nificantly higher in the intervention group (61.9% vs. 24.0%, p=0.016). Appropriate antibiotic transitions occurred more frequently in the intervention group (85.7% vs. 40.0%, p=0.002). Although the time to transition was longer in the intervention group (median 13.3 vs. 5.8 days, p=0.204), follow-up blood cultures were performed more often (95.2% vs. 72.0%). No significant difference in 60-day recurrence rates was observed between the two groups.
Conclusion : This study examined antibiotic use in E. coli bloodstream infections, finding that interventions led to increased appropriate antibiotic transitions and reduced broad-spectrum antibiotic usage. Follow-up culture negativity and recurrence rates were similar between groups, though caution is warranted due to the small sample size and patient variability. Close collaboration with the antibiotic stewardship team is vital to ensure safe, evidence-based de-escalation practices.