Sepsis & septic shock · Duration of antibiotic therapy
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections
| Design | Multicentre, non-inferiority randomised controlled trial across 74 hospitals in seven countries |
|---|---|
| Treatment | 7 days of antibiotic treatment |
| Control | 14 days of antibiotic treatment |
| Population | 3608 hospitalised patients with bloodstream infection |
| Follow-up | 90 days |
| Primary endpoint | 90-day all-cause mortality, tested for non-inferiority |
| Result | 1814 patients were assigned to 7 days and 1794 to 14 days. Seven days was non-inferior to 14 days for 90-day mortality. |
| Secondary endpoints | Relapse of bacteraemia, Clostridioides difficile infection, antimicrobial resistance, ICU and hospital stay |
Among hospitalized patients with bloodstream infection, antibiotic treatment for 7 days was noninferior to treatment for 14 days.
The trial authors, in the published abstract
Extends the short-course principle of PneumA to bacteraemia, in one of the largest antibiotic duration trials ever run. Halving treatment in this population removes an enormous amount of antibiotic exposure with no measurable cost.
Daneman N, Rishu A, Pinto R, et al. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. N Engl J Med 2025 Mar 13;392(11):1065-1078.