N Engl J Med

Shorter antibiotic treatment duration effective for bloodstream infections

November 28, 2024

Study design: The randomized BALANCE trial compared the efficacy and safety of 7-day vs. 14-day antibiotic treatment in patients with bloodstream infections. Conducted across multiple centers, the study enrolled adult patients diagnosed with bloodstream infections, assessing clinical outcomes, microbiological clearance, and adverse events.

Results: No significant difference in clinical outcomes was found between the two groups. Patients receiving 7 days of antibiotics had similar rates of treatment failure and adverse events compared with those treated for 14 days. By 90 days, 14.5% of participants in the 7-day group had died vs. 16.1% of those in the 14-day group, demonstrating noninferiority of the shorter treatment duration.

Impact on clinical practice: These results support the use of a 7-day antibiotic regimen for patients with bloodstream infections, potentially improving antibiotic stewardship and minimizing resistance and adverse effects.

Source:

Daneman N, et al; BALANCE Investigators, for the Canadian Critical Care Trials Group, the Association of Medical Microbiology and Infectious Disease Canada Clinical Research Network, the Australian and New Zealand Intensive Care Society Clinical Trials Group, and the Australasian Society for Infectious Diseases Clinical Research Network. (2024, November 20). N Engl J Med. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. https://pubmed.ncbi.nlm.nih.gov/39565030/