Healthcare (Commonwealth Union) – Bloodstream infections, also known as bloodstream infections (BSIs) or septicemia, occur when microorganisms such as bacteria, fungi, or viruses enter the bloodstream and spread throughout the body. These infections can lead to severe complications and, if left untreated, can be life-threatening.
Bloodstream infections are treated with antibiotics. The choice of antibiotic depends on the type of pathogen identified in the blood cultures. In some cases, a combination of antibiotics may be necessary. Additionally, patients may require treatment for the underlying condition or infection that caused the bloodstream infection. In severe cases, patients may require hospitalization for intravenous antibiotics, supportive care, and monitoring. In some instances, surgery may be required to remove infected tissue or treat the underlying cause of the infection.
A global clinical trial involving researchers from Monash University, which studied over 3,600 patients across 74 hospitals, has demonstrated that lengthy antibiotic treatments for bloodstream infections may not be necessary.
Associate Professor Benjamin Rogers, from Monash’s Centre for Inflammatory Diseases and Monash Health, highlighted the gravity of bloodstream infections, which claim around three million lives globally each year. Traditionally, these severe and potentially fatal conditions have been managed with extended antibiotic courses.
Associate Professor Rogers indicated that patients diagnosed with bloodstream infections are often critically ill, and even with prompt antibiotic treatment, recovery can take time. He further pointed out that for decades, the standard approach has been a two-week antibiotic regimen. However, their study reveals that the initial severity of illness does not dictate the required duration of treatment.
The findings, published in the New England Journal of Medicine, come from the largest randomized trial ever conducted on bloodstream infections. The study showed that a shorter, one-week course of antibiotics for adults hospitalized with sepsis caused by bloodstream infections is just as effective as the conventional two-week treatment.
The research, led by the Sunnybrook Research Institute in Canada, was coordinated in Australia by Monash Health and Monash University, with support from the Australian National Health and Medical Research Council.
Associate Professor Rogers indicated that antibiotics were extremely vital at early stages of infections – “but what we didn’t know is that in many patients you could actually just stop them after a week”. He said it was a “very robust finding” from a large randomised controlled trial. The final measure was the number of patients who were alive 90 days after the infection. “We showed that whether you had one week or two weeks of treatment, a similar proportion of people were still alive,” he added.
One of the key researchers in the trial, Dr Nick Daneman, of the Tory Trauma Research Program at Sunnybrook, pointed out that sepsis as well as antibiotics were under-researched.
“Our aim was to determine if shorter or longer treatment durations had an impact on patient outcomes to help inform future treatment recommendations.”
The BALANCE trial (Bacteremia Antibiotic Length Actually Needed for Clinical Effectiveness) involved 3,608 patients and revealed comparable outcomes for different treatment durations. At 90 days, 14.5 percent of patients treated with a seven-day course of antibiotics had died, compared to 16.1 percent of those who received a 14-day course. The study was a collaborative effort, including researchers from Australia, Canada, New Zealand, the Middle East, and Europe.
Dr. Rob Fowler, chief scientist of Sunnybrook’s Tory Trauma Program and co-lead investigator a single week of antibiotics works just as effectively as two weeks. He further indicated that this evidence can guide healthcare decisions, leading to cost savings and reducing antimicrobial resistance at both individual and population levels.
As antibiotic resistance has become a global crisis in hospitals and healthcare settings, the findings may provide a key remedy to the issue.
