Seven days of antibiotics noninferior to 14 days for hospitalized patients with bloodstream infection
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Nov. 27, 2024 (HealthDay News) — Antibiotic treatment for seven days is noninferior to 14 days for hospitalized patients with bloodstream infection, according to a study published online Nov. 20 in the New England Journal of Medicine to coincide with the Critical Care Canada Forum, held from Nov. 17 to 20 in Toronto.
Nick Daneman, M.D., from the University of Toronto, and colleagues randomly assigned 3,608 hospitalized patients from 74 hospitals in seven countries who had bloodstream infections to receive antibiotic treatment for seven or 14 days (1,814 and 1,794, respectively). Death from any cause by 90 days after diagnosis of the bloodstream infection was measured as the primary outcome, with a noninferiority margin of 4 percentage points.
The researchers found that by 90 days, 14.5 and 16.1 percent of those receiving antibiotics for seven and 14 days had died, respectively, which showed the noninferiority of shorter treatment duration. In 23.1 and 10.7 percent of patients in the seven- and 14-day groups, respectively, patients were treated for longer than the assigned duration. Noninferiority was also seen in the per-protocol analysis. Across secondary clinical outcomes and prespecified subgroups defined according to patient, pathogen, and syndrome characteristics, the findings were consistent.
“Although seven days of treatment was noninferior to 14 days of treatment, further research is needed to test individualized and potentially shorter treatment durations, so that each patient receives just as long a course as is needed and to balance the benefits and possible harms of antibiotic treatment more fully,” the authors write.
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