Résumé
Empiric antimicrobial therapy recommended for intra-abdominal infections (IAI) is based on beta-lactam (BL) use. In case of BL allergy, alternative regimens without BL are recommended. The aim of this study was to compare the outcomes of BL allergic (BLA) patients with IAI treated without BL to those non BLA (NBLA) treated with BL. Method: we conducted a case-control study in a french teaching hospital, between 01/01/2016 and 08/31/2021. The cases, BLA patients with IAI treated with fluoroquinolone or aztreonam and metronidazole, were matched with control treated with BL on age, sex, disease severity, IAI localization, and health care-associated nature of IAI. We compared the rates of therapeutic failures, adverse events and health care-associated infections (HAIs) in both groups, then we assessed factors associated with therapeutic failure using a logistic regression model. Results: we included 43 patients in each group (N=86) which were well balanced. The rate of therapeutic failure was at 14% in both groups (P>0.99). There was no significant difference in the rates of HAI (P=0.154) and adverse events related to antibiotics (P>0.99). Factors independently associated with therapeutic failure were higher BMI, odd ratio (OR) 1.16 95% confidence interval (95%CI) [1.00-1.36], P=0.041, higher hospital length of stay, OR 1,20 95%CI [1.08-1.41], P=0.006, and inadequate empiric antimicrobial therapy, OR 11.71 95%CI [1.43-132.46], P=0.025. None of the antimicrobial regimens were associated with therapeutic failure. Conclusion: the outcomes of BLA patients with IAI treated without BL was the same than NBLA patients treated with conventional BL-based regimens.