Abstract Background Short course antibiotic therapy (4 days) following source control for intraabdominal infections has become standard of care. However, recent data suggests that ultra-long course durations (28 days) after source control may drastically reduce recurrence rates. A randomized trial of ultra-long course therapy for complicated intraabdominal infections is currently enrolling. The purpose of this study is to evaluate these two treatment strategies using a decision analysis model. Methods A decision tree was created from the perspective of a healthcare administrator. The model evaluates the rates of recurrence between these two treatment strategies as well as potential negative impacts of overtreatment and per-day risk of antibiotic-associated adverse events. Model values were taken from the published literature or estimated by the authors. Base-case and probabilistic sensitivity analyses were performed. The model was created using TreeAge Pro Healthcare (TreeAge Software, Inc., Williamstown, MA). Results On base-case analysis, short course therapy maximized utility with an overall utility of 0.97 versus 0.92 for ultra-long course therapy. Probabilistic sensitivity analysis, after 100,000 iterations identified short course therapy as the optimal strategy for 99% of model iterations. Conclusion In this exploratory model, short course therapy resulted in higher overall utility values compared to ultra-long course treatment. Further work is needed to confirm these findings, including completion of the currently enrolling EXTEND trial. Disclosures All Authors: No reported disclosures
Guidry et al. (Thu,) studied this question.