• LOGIN
Repository logo

BORIS Portal

Bern Open Repository and Information System

  • Publication
  • Projects
  • Funding
  • Research Data
  • Organizations
  • Researchers
  • LOGIN
Repository logo
Unibern.ch
  1. Home
  2. Publications
  3. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections.
 

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

Options
  • Details
BORIS DOI
10.48620/77073
Date of Publication
March 13, 2025
Publication Type
Article
Division/Institute

Clinic of Intensive C...

Author
Daneman, Nick
Rishu, Asgar
Pinto, Ruxandra
Rogers, Benajmin A
Shehabi, Yahya
Parke, Rachael
Cook, Deborah
Arabi, Yaseen
Muscedere, John
Reynolds, Steven
Hall, Richard
Dwivedi, Dhiraj B
McArthur, Colin
McGuinness, Shay
Yahav, Dafna
Coburn, Bryan
Geagea, Anna
Das, Pavani
Shin, Phillip
Detsky, Michael
Morris, Andrew
Fralick, Michael
Powis, Jeff E
Kandel, Christopher
Sligl, Wendy
Bagshaw, Sean M
Singhal, Nishma
Belley-Cote, Emilie
Whitlock, Richard
Khwaja, Kosar
Morpeth, Susan
Kazemi, Alex
Williams, Anthony
MacFadden, Derek R
McIntyre, Lauralyn
Tsang, Jennifer
Lamontagne, Francois
Carignan, Alex
Marshall, John
Friedrich, Jan O
Cirone, Robert
Downing, Mark
Graham, Christopher
Davis, Joshua
Duan, Erick
Neary, John
Evans, Gerald
Alraddadi, Basem
Al Johani, Sameera
Martin, Claudio
Elsayed, Sameer
Ball, Ian
Lauzier, Francois
Turgeon, Alexis
Stelfox, Henry T
Conly, John
McDonald, Emily G
Lee, Todd C
Sullivan, Richard
Grant, Jennifer
Kagan, Ilya
Young, Paul
Lawrence, Cassie
O'Callaghan, Kevin
Eustace, Matthew
Choong, Keat
Aslanian, Pierre
Buehner, Ulrike
Havey, Tom
Binnie, Alexandra
Prazak, Josef
Clinic of Intensive Care Medicine
Reeve, Brenda
Litton, Edward
Lother, Sylvain
Kumar, Anand
Zarychanski, Ryan
Hoffman, Tomer
Paterson, David
Daley, Peter
Commons, Robert J
Charbonney, Emmanuel
Naud, Jean-Francois
Roberts, Sally
Tiruvoipati, Ravindranath
Gupta, Sachin
Wood, Gordon
Shum, Omar
Miyakis, Spiros
Dodek, Peter
Kwok, Clement
Fowler, Robert A
Subject(s)

600 - Technology::610...

Series
New England Journal of Medicine
ISSN or ISBN (if monograph)
1533-4406
0028-4793
Publisher
Massachusetts Medical Society
Language
English
Publisher DOI
10.1056/NEJMoa2404991
PubMed ID
39565030
Description
Background
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.).
Handle
https://boris-portal.unibe.ch/handle/20.500.12422/190648
Show full item
File(s)
FileFile TypeFormatSizeLicensePublisher/Copright statementContent
NEJMoa2404991.pdftextAdobe PDF569.55 KBpublished restricted
BORIS Portal
Bern Open Repository and Information System
Build: 360c85 [14.04. 8:05]
Explore
  • Projects
  • Funding
  • Publications
  • Research Data
  • Organizations
  • Researchers
More
  • About BORIS Portal
  • Send Feedback
  • Cookie settings
  • Service Policy
Follow us on
  • Mastodon
  • YouTube
  • LinkedIn
UniBe logo