7 days
non-inferior to 14 days of antibiotic therapy for uncomplicated Gram-negative
bacteremia
In patients hospitalized with uncomplicated
Gram-negative bacteremia, an antibiotic course of 7 days was non-inferior to 14
days, according to a randomized, multicenter trial published in Clinical
Infectious Diseases, an official journal of the Infectious Diseases Society of
America (IDSA).
The study conducted in three centers in Israel and
Italy examined 604 hospitalized patients with uncomplicated i.e. afebrile
and hemodynamically stable for at least 48 hours, gram-negative bacteremia
(mostly Enterobacteriaceae). The patients were randomized to antibiotic
treatment for 7 days and 14 days.
The primary outcome - composite of all-cause
mortality; relapse, suppurative or distant complications and re-admission or
extended hospitalization (>14 days) – rates were comparable in the two
groups; 46 in the 7 days group vs 48.3% in the 14 days group suggesting that
the 7-day course of antibiotic was non-inferior to the longer course.
Hence, patients who respond to the antibiotic may
be given a 7-day treatment instead of 14 days.
(Reference: Yahav D, et
al. Seven versus fourteen days of antibiotic therapy for uncomplicated
gram-negative bacteremia: a non-inferiority randomized controlled trial. Clin
Infect Dis. 2018 Dec 11. doi: 10.1093/cid/ciy1054. Epub ahead of print)
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical
Associations in Asia and Oceania
(CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA
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