Development and validation of a nomogram for predicting antibiotic treatment duration in patients with liver abscess complicated by diabetes

This study aimed to identify the recovery predictors for patients with pyogenic liver abscess (PLA) and diabetes who are undergoing antibiotic therapy, and to develop an effective nomogram for predicting the antibiotic treatment duration (ORT). This retrospective study included consecutive PLA patients with diabetes who received antibiotic treatment, with ORT defined as the time from the initiation of antibiotic therapy to its cessation. Univariate and multivariate analyses were performed to identify the main predictors of ORT. Kaplan-Meier survival curves and a nomogram were subsequently constructed to predict ORT, and the accuracy of the nomogram was assessed using Harrell's C-statistic and calibration curves. A total of 139 PLA patients with diabetes were included, with a median ORT of 17 days (interquartile range: 13-22 days). The study found that fever (P < 0.01), pre-treatment septic shock (P < 0.01), abscess diameter greater than 5 cm (P < 0.01), and elevated white blood cell count (P = 0.04) were independent risk factors for prolonged ORT, suggesting that patients with these factors had a significantly longer ORT compared to those without them. Prognostic analysis showed that patients exhibiting more predictive factors (e.g., high fever, shock, larger abscess, elevated white blood cell count) had a significantly extended ORT. Based on these factors, we developed a nomogram to predict ORT, with a Harrell's C-statistic of 0.75, indicating good predictive accuracy. The calibration curve for predicting ORT demonstrated good consistency between the expected and actual results. This nomogram provides clinicians with a simple and practical tool to assess patient prognosis and guide the appropriate cessation of antibiotic treatment.