Background: The duration of antibiotic therapy for bacteremia due to Enterobacteriaceae is not well-defined. We sought to evaluate the clinical outcomes with shorter versus longer-course treatment.
Methods: We performed a systematic search of the PubMed and EMBASE databases through May 2018. Studies presenting comparative outcomes between patients receiving antibiotic treatment for ≤10 days ("short-course") and those treated for >10 days ("long-course") were considered eligible.
Results: Four retrospective cohort studies and one randomized controlled trial comprising 2,865 patients met the inclusion criteria. Short and long-course antibiotic treatment did not differ in 30-day all-cause mortality (1,374 patients, RR= 0.99, 95% CI (0.69-1.43)), 90-day all-cause mortality (1,750 patients, RR= 1.16 (95% CI, 0.81-1.66)), clinical cure (1,080 patients, RR= 1.02 (95% CI, 0.96-1.08)), or relapse at 90 days (1,750 patients, RR= 1.08 95% CI (0.69-1.67)).
Conclusions: In patients with bacteremia due to Enterobacteriaceae, short and long-course antibiotic treatment did not differ significantly in terms of clinical outcomes. Further well-designed studies are needed before treatment for 10 days or less is adopted in clinical practice.
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