Infection · 2025
Antimicrobial treatment for 7 versus 14 days in patients with bacteremia: a meta-analysis of randomized controlled trials.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Prager Marlene, Bergmann Felix, Pracher Lena, Copic Dragan, Zessner-Spitzenberg Jasmin, Gelbenegger Georg, Lagler Heimo, Harrison Nicole, Burgmann Heinz, Zeitlinger Markus, Jorda Anselm
Аннотация
PURPOSE: The optimal duration of antibiotic treatment in patients with bacteremia is a matter of ongoing debate.
METHODS: We conducted a meta-analysis of randomized controlled trials that compared 7 days with 14 days of antimicrobial treatment in adults with bacteremia. The systematic search included trials published until December 2024. Efficacy outcomes included 90-day all-cause mortality, recurrence of bacteremia and mean length of hospital stay. Safety outcomes included the total number of adverse events, Clostridioides difficile infections, diarrhea, acute kidney injury, rash or emergence of antibiotic resistance.
RESULTS: The final analysis included four randomized controlled trials with a total of 4790 participants. Death by day 90 occurred in 321 (13.3%) of 2406 patients receiving antibiotic treatment for 7 days and 342 (14.3%) of 2384 patients receiving antibiotic treatment for 14 days (RR 0.93 [95% CI, 0.81 to 1.07)]; p = 0.30; prediction interval 0.74 to 1.17). The mean hospital stay did not differ significantly (mean difference - 0.18 days [95% CI, -1.03 to 0.67]; p = 0.69; prediction interval - 2.57 to 2.22). Recurrence of bacteremia was similar between antibiotic treatment for 7 days (64 [2.7%] of 2406) and antibiotic treatment for 14 days (56 [2.3%] of 2384) (RR 1.14 [95% CI, 0.80 to 1.63)]; p = 0.47; prediction interval 0.64 to 2.03). Safety outcomes, including the total number of adverse events, Clostridioides difficile infections, diarrhea, acute kidney injury, rash, and antibiotic resistance, were similar between groups.
CONCLUSIONS: This meta-analysis suggests that 7-day and 14-day antimicrobial treatment is associated with a similar efficacy and safety profile in patients with bacteremia.
METHODS: We conducted a meta-analysis of randomized controlled trials that compared 7 days with 14 days of antimicrobial treatment in adults with bacteremia. The systematic search included trials published until December 2024. Efficacy outcomes included 90-day all-cause mortality, recurrence of bacteremia and mean length of hospital stay. Safety outcomes included the total number of adverse events, Clostridioides difficile infections, diarrhea, acute kidney injury, rash or emergence of antibiotic resistance.
RESULTS: The final analysis included four randomized controlled trials with a total of 4790 participants. Death by day 90 occurred in 321 (13.3%) of 2406 patients receiving antibiotic treatment for 7 days and 342 (14.3%) of 2384 patients receiving antibiotic treatment for 14 days (RR 0.93 [95% CI, 0.81 to 1.07)]; p = 0.30; prediction interval 0.74 to 1.17). The mean hospital stay did not differ significantly (mean difference - 0.18 days [95% CI, -1.03 to 0.67]; p = 0.69; prediction interval - 2.57 to 2.22). Recurrence of bacteremia was similar between antibiotic treatment for 7 days (64 [2.7%] of 2406) and antibiotic treatment for 14 days (56 [2.3%] of 2384) (RR 1.14 [95% CI, 0.80 to 1.63)]; p = 0.47; prediction interval 0.64 to 2.03). Safety outcomes, including the total number of adverse events, Clostridioides difficile infections, diarrhea, acute kidney injury, rash, and antibiotic resistance, were similar between groups.
CONCLUSIONS: This meta-analysis suggests that 7-day and 14-day antimicrobial treatment is associated with a similar efficacy and safety profile in patients with bacteremia.