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Questions and Answers
What is the suggested maximum duration of antibiotic therapy for bacteremia according to the findings?
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?
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?
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?
What was the primary focus of the BALANCE trial?
What future efforts are hoped for regarding the treatment duration for bacteremia?
What future efforts are hoped for regarding the treatment duration for bacteremia?
Why was the management of bacteremic infections with 14 days of therapy questioned?
Why was the management of bacteremic infections with 14 days of therapy questioned?
Which antibiotic treatment duration was recommended for routine management of bacteremic infections?
Which antibiotic treatment duration was recommended for routine management of bacteremic infections?
Which statement about antibiotic treatment for bacteremia is accurate?
Which statement about antibiotic treatment for bacteremia is accurate?
What was the traditional duration of intravenous antibiotic therapy for non–Staphylococcus aureus bacteremic infections?
What was the traditional duration of intravenous antibiotic therapy for non–Staphylococcus aureus bacteremic infections?
What primary outcome was measured in the trial assessing antibiotic treatment duration for bacteremia?
What primary outcome was measured in the trial assessing antibiotic treatment duration for bacteremia?
What percentage of patients were hospitalized in an ICU among the evaluable patients in the study?
What percentage of patients were hospitalized in an ICU among the evaluable patients in the study?
Which complication did not show significant differences between the 7-day and 14-day antibiotic groups?
Which complication did not show significant differences between the 7-day and 14-day antibiotic groups?
What was the percentage of patients with gram-negative bacteria among the infections in the study?
What was the percentage of patients with gram-negative bacteria among the infections in the study?
What was observed regarding the median number of antibiotic-free days between the groups?
What was observed regarding the median number of antibiotic-free days between the groups?
In the context of the study, which population was excluded from participation?
In the context of the study, which population was excluded from participation?
What was the mortality rate for the 7-day antibiotic group after 90 days?
What was the mortality rate for the 7-day antibiotic group after 90 days?
Flashcards
Bacteremia
Bacteremia
A type of infection where bacteria are found in the bloodstream.
BALANCE Trial
BALANCE Trial
A clinical trial designed to determine if a shorter duration of antibiotic treatment is as effective as a longer duration.
7-day antibiotic therapy for bacteremia
7-day antibiotic therapy for bacteremia
Shortened treatment duration for uncomplicated bacteremia (7 days) is non-inferior to the standard 14 days.
Exclusion criteria in the BALANCE Trial
Exclusion criteria in the BALANCE Trial
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Uncomplicated bacteremia
Uncomplicated bacteremia
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90-day mortality
90-day mortality
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Community-acquired infections
Community-acquired infections
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Non-inferiority
Non-inferiority
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What is the BALANCE Trial?
What is the BALANCE Trial?
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What is uncomplicated bacteremia?
What is uncomplicated bacteremia?
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Who was excluded from the BALANCE Trial?
Who was excluded from the BALANCE Trial?
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What did the BALANCE Trial find?
What did the BALANCE Trial find?
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What does "non-inferiority" mean in the context of the BALANCE Trial?
What does "non-inferiority" mean in the context of the BALANCE Trial?
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What was the primary outcome measured in the BALANCE Trial?
What was the primary outcome measured in the BALANCE Trial?
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What does the finding of similar 90-day mortality rates between the two groups imply?
What does the finding of similar 90-day mortality rates between the two groups imply?
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What are the implications of the BALANCE Trial findings?
What are the implications of the BALANCE Trial findings?
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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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