Antibiotic Treatment Duration for Bacteremia
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Questions and Answers

What is the suggested maximum duration of antibiotic therapy for bacteremia according to the findings?

  • 3 days
  • 7 days (correct)
  • 14 days
  • 5 days
  • What condition may still require more than 7 days of antibiotics despite the findings?

  • Underlying immune deficiencies (correct)
  • No underlying conditions
  • Chronic kidney disease
  • Severe allergic reactions
  • Which group conducted the trial discussed in the document?

  • The European Infectious Disease Society
  • The American Medical Association
  • The World Health Organization
  • The Canadian Critical Care Trials Group (correct)
  • What was the primary focus of the BALANCE trial?

    <p>Antibiotic treatment for 7 days versus 14 days</p> Signup and view all the answers

    What future efforts are hoped for regarding the treatment duration for bacteremia?

    <p>Conducting more controlled trials to shorten treatment lengths</p> Signup and view all the answers

    Why was the management of bacteremic infections with 14 days of therapy questioned?

    <p>There is no objective data supporting the duration</p> Signup and view all the answers

    Which antibiotic treatment duration was recommended for routine management of bacteremic infections?

    <p>7 days or less</p> Signup and view all the answers

    Which statement about antibiotic treatment for bacteremia is accurate?

    <p>The necessity for longer durations is yet to be established.</p> Signup and view all the answers

    What was the traditional duration of intravenous antibiotic therapy for non–Staphylococcus aureus bacteremic infections?

    <p>14 days</p> Signup and view all the answers

    What primary outcome was measured in the trial assessing antibiotic treatment duration for bacteremia?

    <p>90-day mortality from any cause</p> Signup and view all the answers

    What percentage of patients were hospitalized in an ICU among the evaluable patients in the study?

    <p>55%</p> Signup and view all the answers

    Which complication did not show significant differences between the 7-day and 14-day antibiotic groups?

    <p>ICU and in-hospital mortality</p> Signup and view all the answers

    What was the percentage of patients with gram-negative bacteria among the infections in the study?

    <p>70%</p> Signup and view all the answers

    What was observed regarding the median number of antibiotic-free days between the groups?

    <p>19 vs. 14 days between groups</p> Signup and view all the answers

    In the context of the study, which population was excluded from participation?

    <p>Patients with Staphylococcus aureus infections</p> Signup and view all the answers

    What was the mortality rate for the 7-day antibiotic group after 90 days?

    <p>14%</p> Signup and view all the answers

    Study Notes

    Antibiotic Treatment Duration for Bacteremia

    • A multinational, controlled trial assessed 7 days of antibiotics versus 14 days for uncomplicated bacteremia.
    • Traditionally, 14 days of IV antibiotics were standard treatment for non- Staphylococcus aureus bacteremia.
    • The study excluded patients with S. aureus infections, neutropenia, severe immunocompromise, prosthetic heart valves, and other prolonged therapy indications.
    • The primary outcome was 90-day mortality.
    • 3608 patients were evaluated; 55% were in the ICU, 21% on mechanical ventilation.
    • Most infections (75%) were community-acquired, with urinary tract (43%), intra-abdominal/hepatobiliary (19%), and pulmonary (13%) as the most frequent sources.
    • Infections were predominantly monomicrobial (gram-negative bacteria 70%, gram-positive 17%).
    • 90-day mortality was 261 (14%) in the 7-day group and 286 (16%) in the 14-day group.
    • Outcomes like ICU and in-hospital mortality, relapse of bacteremia, and C. diff infection showed no significant difference between groups.
    • The findings support shorter 7-day antibiotic regimens for gram-negative bacteremia.

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    Description

    This quiz explores the findings of a multinational trial that compared 7 days versus 14 days of antibiotic treatment for uncomplicated bacteremia. With a focus on mortality outcomes and infection sources, the quiz will test your understanding of antibiotic protocols in critical settings. Prepare to delve into important clinical details and results.

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