Work

Duration of Antibiotic Therapy for Escherichia coli Bacteremia in Infants With Normal Cerebrospinal Fluid Studies and Without Meningitis.

Year: 2026

Type: article

Abstract: OBJECTIVE: bacteremia with reliable, normal cerebrospinal fluid (CSF) studies and without meningitis is unknown. We evaluated whether treatment duration is associated with infection recurrence or mortality in these infants. METHODS: bacteremia. Exclusion criteria included absence of CSF test results, CSF pleocytosis, positive culture or Gram stain from the CSF, delayed antimicrobial initiation (>2 days), or death/discharge during therapy. Antibiotic duration was categorized as <10, 10 to 14, or >14 days. Univariable analysis and multivariable logistic regression were used to assess associations between antibiotic duration and 30-day and in-hospital mortality, recurrence of infection, and the combined outcome of recurrence of infection or 30-day mortality. Sensitivity analysis excluded courses <5 days. RESULTS: bacteremia, recurrence of infection or death following antibiotics occurred in 3% and was not associated with antibiotic duration (p = 0.82). After adjusting for gestational age and severe disease (defined as 1 or more of the following: mechanical ventilation, inotropic administration, or extracorporeal support) on the first day of bacteremia, antibiotic durations of 10 to 14 days were associated with lower odds of 30-day mortality (OR 0.18; 95% CI: 0.03-0.99) than antibiotic durations of <10 days. In the sensitivity analysis (N = 667), antibiotic duration was not predictive of any outcomes. CONCLUSIONS: bacteremia with normal CSF results is likely sufficient for term and preterm infants.

Source: PubMed

DOI: 10.5863/jppt-25-00150