Search
gram-negative sepsis; gram-negative bacteremia
Laboratory:
- C-reactive protein in serum to guide treatment*
- antibiotics may be discontinued when serum CRP decreases to 25% of peak value [1]
* study falls short of proving that CRP-guided therapy is worthwhile for patients with gram-negative bacteremia [1]
* benefit if any is with antibiotic stewardship
Management:
- 7 days vs 14 days of antibiotic treatment standard [1]
- for patients responding to IV antibiotics, switch to oral antibiotics after 3-5 days [2]
General
sepsis
gram-negative infection
References
- von Dach E, Albrich WC, Brunel AS et al.
Effect of C-reactive protein-guided antibiotic treatment duration,
7-day treatment, or 14-day treatment on 30-day clinical failure rate
in patients with uncomplicated gram-negative bacteremia: A randomized
clinical trial.
JAMA 2020 Jun 2; 323:2160
PMID: 32484534 Free PMC article
https://doi.org/10.1001/jama.2020.6348
- Omrani AS, Abujarir SH, Ben Abid F et al.
Switch to oral antibiotics in gram-negative bacteraemia; A randomised, open-label,
clinical trial.
Clin Microbiol Infect 2023 Oct 17; [e-pub].
PMID: 37858867
https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(23)00522-0/fulltext