A seven-day antibiotic course for patients with bloodstream infections was as effective as a 14-day course, and it had a lower mortality rate, a recent study found.
The study, published on clinicaltrials.gov, used information from 3,631 patients with bloodstream infections from 74 hospitals in Australia, Canada, Israel, New Zealand, Saudi Arabia, Switzerland, and the United States. Patients had a range of infections, with the most common being urinary tract, lung and abdominal infections. More than half of the patients were admitted to the intensive care unit at the time of the study.
The researchers reviewed literature on typical antibiotic courses globally and found that 14-day courses were the most common.
Researchers found patients who underwent the seven-day treatment had a 14.5% 90-day mortality rate, whereas the 14-day treatment yielded a 16.1% mortality rate at 90 days. They also found seven-day treatment was more effective in other outcomes, including ICU mortality, hospital mortality and relapse of bloodstream infection.
"We also found that getting 7-day treatment up front led to less total antibiotic use in follow-up and shorter lengths of stay in the hospital," Nick Daneman, MD, clinician scientist in the division of infectious diseases at Sunnybrook Health Sciences Centre in Toronto, Ontario, Canada, said at the Infectious Disease Week 2024 Annual Meeting. "We can say really clearly here that 7 days is noninferior in the treatment of bloodstream infections."
There are about 600,000 cases of bloodstream infections each year, with about 90,000 resulting in death in North America alone. Before this trial, there had been no randomized trials on antibiotic courses and bloodstream infections, the study authors said.