![]() ![]() ![]() Published by Oxford University Press for the Infectious Diseases Society of America. Reducing antibiotic treatment for uncomplicated gram-negative bacteremia to 7 days is an important antibiotic stewardship intervention.Īntibiotics bacteremia duration gram-negative. In patients hospitalized with gram-negative bacteremia achieving clinical stability before day 7, an antibiotic course of 7 days was noninferior to 14 days. No significant differences were observed in all other outcomes and adverse events, except for a shorter time to return to baseline functional status in the short-course therapy arm. The primary outcome occurred in 140 of 306 patients (45.8%) in the 7-day group vs 144 of 298 (48.3%) in the 14-day group (risk difference, -2.6% ). A 7-day difference in the median duration of covering antibiotics was achieved. Carbapenems are broad-spectrum parenteral antimicrobials that have activity against gram-positive, gram-negative, and anaerobic bacteria. The source of the infection was urinary in 411 of 604 patients (68%) causative pathogens were mainly Enterobacteriaceae (543/604 ). We included 604 patients (306 intervention, 298 control) between January 2013 and August 2017 in 3 centers in Israel and Italy. ![]() The noninferiority margin was set at 10%. The primary outcome at 90 days was a composite of all-cause mortality relapse, suppurative, or distant complications and readmission or extended hospitalization (>14 days). Patients with uncontrolled focus of infection were excluded. Anaerobes - Bacteroides spp., generally in more serious infections, or in patients with a history of biliary manipulations. Inpatients with gram-negative bacteremia, who were afebrile and hemodynamically stable for at least 48 hours, were randomized to receive 7 days (intervention) or 14 days (control) of covering antibiotic therapy. coli, Klebsiella spp, Proteus spp, Pseudomonas (mainly in patients already on broad-spectrum antibiotics or those who have undergone prior procedures). This was a randomized, multicenter, open-label, noninferiority trial. Data to guide the duration of antibiotic therapy are limited. Gram-negative bacteremia is a major cause of morbidity and mortality in hospitalized patients. ![]()
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