Publication:
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections.

cris.virtualsource.author-orcid47e7580f-f500-46f6-b940-d755ef3d4b87
dc.contributor.authorDaneman, Nick
dc.contributor.authorRishu, Asgar
dc.contributor.authorPinto, Ruxandra
dc.contributor.authorRogers, Benajmin A
dc.contributor.authorShehabi, Yahya
dc.contributor.authorParke, Rachael
dc.contributor.authorCook, Deborah
dc.contributor.authorArabi, Yaseen
dc.contributor.authorMuscedere, John
dc.contributor.authorReynolds, Steven
dc.contributor.authorHall, Richard
dc.contributor.authorDwivedi, Dhiraj B
dc.contributor.authorMcArthur, Colin
dc.contributor.authorMcGuinness, Shay
dc.contributor.authorYahav, Dafna
dc.contributor.authorCoburn, Bryan
dc.contributor.authorGeagea, Anna
dc.contributor.authorDas, Pavani
dc.contributor.authorShin, Phillip
dc.contributor.authorDetsky, Michael
dc.contributor.authorMorris, Andrew
dc.contributor.authorFralick, Michael
dc.contributor.authorPowis, Jeff E
dc.contributor.authorKandel, Christopher
dc.contributor.authorSligl, Wendy
dc.contributor.authorBagshaw, Sean M
dc.contributor.authorSinghal, Nishma
dc.contributor.authorBelley-Cote, Emilie
dc.contributor.authorWhitlock, Richard
dc.contributor.authorKhwaja, Kosar
dc.contributor.authorMorpeth, Susan
dc.contributor.authorKazemi, Alex
dc.contributor.authorWilliams, Anthony
dc.contributor.authorMacFadden, Derek R
dc.contributor.authorMcIntyre, Lauralyn
dc.contributor.authorTsang, Jennifer
dc.contributor.authorLamontagne, Francois
dc.contributor.authorCarignan, Alex
dc.contributor.authorMarshall, John
dc.contributor.authorFriedrich, Jan O
dc.contributor.authorCirone, Robert
dc.contributor.authorDowning, Mark
dc.contributor.authorGraham, Christopher
dc.contributor.authorDavis, Joshua
dc.contributor.authorDuan, Erick
dc.contributor.authorNeary, John
dc.contributor.authorEvans, Gerald
dc.contributor.authorAlraddadi, Basem
dc.contributor.authorAl Johani, Sameera
dc.contributor.authorMartin, Claudio
dc.contributor.authorElsayed, Sameer
dc.contributor.authorBall, Ian
dc.contributor.authorLauzier, Francois
dc.contributor.authorTurgeon, Alexis
dc.contributor.authorStelfox, Henry T
dc.contributor.authorConly, John
dc.contributor.authorMcDonald, Emily G
dc.contributor.authorLee, Todd C
dc.contributor.authorSullivan, Richard
dc.contributor.authorGrant, Jennifer
dc.contributor.authorKagan, Ilya
dc.contributor.authorYoung, Paul
dc.contributor.authorLawrence, Cassie
dc.contributor.authorO'Callaghan, Kevin
dc.contributor.authorEustace, Matthew
dc.contributor.authorChoong, Keat
dc.contributor.authorAslanian, Pierre
dc.contributor.authorBuehner, Ulrike
dc.contributor.authorHavey, Tom
dc.contributor.authorBinnie, Alexandra
dc.contributor.authorPrazak, Josef
dc.contributor.authorReeve, Brenda
dc.contributor.authorLitton, Edward
dc.contributor.authorLother, Sylvain
dc.contributor.authorKumar, Anand
dc.contributor.authorZarychanski, Ryan
dc.contributor.authorHoffman, Tomer
dc.contributor.authorPaterson, David
dc.contributor.authorDaley, Peter
dc.contributor.authorCommons, Robert J
dc.contributor.authorCharbonney, Emmanuel
dc.contributor.authorNaud, Jean-Francois
dc.contributor.authorRoberts, Sally
dc.contributor.authorTiruvoipati, Ravindranath
dc.contributor.authorGupta, Sachin
dc.contributor.authorWood, Gordon
dc.contributor.authorShum, Omar
dc.contributor.authorMiyakis, Spiros
dc.contributor.authorDodek, Peter
dc.contributor.authorKwok, Clement
dc.contributor.authorFowler, Robert A
dc.date.accessioned2024-12-02T10:09:29Z
dc.date.available2024-12-02T10:09:29Z
dc.date.issued2024-11-20
dc.description.abstractBackground Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain.Methods In a multicenter, noninferiority trial, we randomly assigned hospitalized patients (including patients in the intensive care unit [ICU]) who had bloodstream infection to receive antibiotic treatment for 7 days or 14 days. Antibiotic selection, dosing, and route were at the discretion of the treating team. We excluded patients with severe immunosuppression, foci requiring prolonged treatment, single cultures with possible contaminants, or cultures yielding Staphylococcus aureus. The primary outcome was death from any cause by 90 days after diagnosis of the bloodstream infection, with a noninferiority margin of 4 percentage points.Results Across 74 hospitals in seven countries, 3608 patients underwent randomization and were included in the intention-to-treat analysis; 1814 patients were assigned to 7 days of antibiotic treatment, and 1794 to 14 days. At enrollment, 55.0% of patients were in the ICU and 45.0% were on hospital wards. Infections were acquired in the community (75.4%), hospital wards (13.4%) and ICUs (11.2%). Bacteremia most commonly originated from the urinary tract (42.2%), abdomen (18.8%), lung (13.0%), vascular catheters (6.3%), and skin or soft tissue (5.2%). By 90 days, 261 patients (14.5%) receiving antibiotics for 7 days had died and 286 patients (16.1%) receiving antibiotics for 14 days had died (difference, -1.6 percentage points [95.7% confidence interval {CI}, -4.0 to 0.8]), which showed the noninferiority of the shorter treatment duration. Patients were treated for longer than the assigned duration in 23.1% of the patients in the 7-day group and in 10.7% of the patients in the 14-day group. A per-protocol analysis also showed noninferiority (difference, -2.0 percentage points [95% CI, -4.5 to 0.6]). These findings were generally consistent across secondary clinical outcomes and across prespecified subgroups defined according to patient, pathogen, and syndrome characteristics.Conclusions Among hospitalized patients with bloodstream infection, antibiotic treatment for 7 days was noninferior to treatment for 14 days. (Funded by the Canadian Institutes of Health Research and others; BALANCE ClinicalTrials.gov number, NCT03005145.).
dc.description.sponsorshipClinic of Intensive Care Medicine
dc.identifier.doi10.48620/77073
dc.identifier.pmid39565030
dc.identifier.publisherDOI10.1056/NEJMoa2404991
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/190648
dc.language.isoen
dc.publisherMassachusetts Medical Society
dc.relation.ispartofNew England Journal of Medicine
dc.relation.issn1533-4406
dc.relation.issn0028-4793
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titleAntibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections.
dc.typearticle
dspace.entity.typePublication
oairecerif.author.affiliationClinic of Intensive Care Medicine
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unibe.description.ispublishedinpress
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unibe.subtype.articlejournal

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