What question did this study set out to answer?

To determine whether a 7-day course of covering antibiotic therapy is noninferior to a 14-day course in hospitalized patients with uncomplicated Gram-negative bacteremia who achieve clinical stability.

December 7, 2018Clinical Infectious DiseasesOpen Access

Seven Versus 14 Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia: A Noninferiority Randomized Controlled Trial

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Authors

DYDafna YahavTel Aviv University EFErica FranceschiniUniversity of Modena and Reggio Emilia FKFidi KoppelRambam Health Care Campus

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Implication

Randomized noninferiority trial demonstrates 7-day antibiotic therapy is noninferior to 14 days in uncomplicated gram-negative bacteremia, supporting shorter treatment duration for stewardship.

Key Points

To determine whether a 7-day course of covering antibiotic therapy is noninferior to a 14-day course in hospitalized patients with uncomplicated Gram-negative bacteremia who achieve clinical stability.
Open-label, multicenter, randomized noninferiority trial conducted at 3 centers in Israel and Italy between January 2013 and August 2017 (NCT01737320).
Enrolled 604 inpatients (n=306 intervention, n=298 control) with Gram-negative bacteremia who were afebrile and hemodynamically stable for ≥48 hours, randomized to 7 or 14 days of covering antibiotics.
The primary outcome was a 90-day composite of all-cause mortality, suppurative/distant complications, relapse, and readmission or extended hospitalization (>14 days), assessed with a 10% noninferiority margin.
The composite primary outcome occurred in 140 of 306 patients (45.8%) in the 7-day group versus 144 of 298 patients (48.3%) in the 14-day group (risk difference: -2.6% [95% CI, -10.5% to 5.3%]), establishing noninferiority.
Patients receiving short-course antibiotic therapy demonstrated a significantly shorter time to return to their baseline functional status compared to the 14-day arm.
No significant differences were detected between the treatment arms regarding adverse events or individual secondary clinical outcomes.

Cite This Study

Yahav et al. (2018) studied this question.

synapsesocial.com/papers/6a8309bca250d11ff44cd11c https://doi.org/10.1093/cid/ciy1054

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Implication

Randomized noninferiority trial demonstrates 7-day antibiotic therapy is noninferior to 14 days in uncomplicated gram-negative bacteremia, supporting shorter treatment duration for stewardship.

Seven Versus 14 Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia: A Noninferiority Randomized Controlled Trial

Discussion

Member takes

Implication

Key Points

Cite This Study

Seven Versus 14 Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia: A Noninferiority Randomized Controlled Trial

Discussion

Member takes

Implication

Key Points

Cite This Study

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