News: Shorter course of antibiotic treatment works for bloodstream infections

A seven-day treatment of antibiotics for patients with bloodstream infections works just as well as a 14-day treatment, MedPage Today reported.

The study, published in BMJ Journal, examined 3,608 patients across 74 hospitals in seven countries. According to the authors, 55% of the patients examined were in the ICU, 75% of infections were community-acquired, 13% were hospital-acquired, and 11% were ICU-acquired.

The “most common sources of bacteremia” were the urinary tract at 42.2%, the abdomen at 18.8%, the lung at 13.0%, the vascular catheters at 6.3%, and the skin or soft tissue 5.2%; moreover, the top three pathogens, according to MedPage Today, were Escherichia coli (44%), Klebsiella spp (15%), and Enterococcus spp (7%).

Here were some of the differentials between the seven-day and 14-day data:

• In-hospital mortality: 9.3% (seven-day) versus 10.3% (14-day)
• ICU mortality: 9.0% (seven-day) versus 9.6% (14-day)
• Length of hospital stay: 10 days (seven-day) versus 11 days (14-day)
• Hospital-free days at 28 days: 17 (seven-day) versus 15 (14-day)
• Antibiotic-free days at 28 days: 19 (seven-day) versus 14 (14-day)

"We were not surprised by our findings, because a growing body of research has shown that shorter treatment durations are sufficient for many other infections," Nick Daneman, MD, MSc, and one of the key researchers in the study told MedPage Today.

However, there were a few pathogens that appeared to be exceptions to the rule. Among them were the Clostridioides difficile and Staphylococcus aureus infections, neutropenic patients, and transplantation patients.

Editor’s note: To read the MedPage Today summary, click here. To read the BMJ Journal article, click here.