Die Tatsächliche Länge der Antibiotischen Behandlung bei Blutstrominfektionen BALANCE Bacteremia Antibiotic Length Actually Needed for Clinical Effectiveness

Other: 7 days of adequate antibiotic treatment;Other: 14 days of adequate antibiotic treatment.

Gender: All
Maximum age: N/A
Minimum age: 18 Years

Inclusion Criteria:

1. Patient is in ICU or non-ICU ward at the time the blood culture is drawn or reported
as positive.

2. Patient has a positive blood culture with pathogenic bacteria.

Exclusion Criteria:

1. Patient already enrolled in the trial

2. Patient has severe immune system compromise, as defined by: absolute neutrophil count
<0.5x109/L; or is receiving immunosuppressive treatment for solid organ or bone marrow
or stem cell transplant

3. Patient has a prosthetic heart valve or synthetic endovascular graft (post major
vessel repair with synthetic material) (note: coronary artery stents are not an
exclusion)

4. Patient has documented or suspected syndrome with well-defined requirement for
prolonged treatment:

i) infective endocarditis; ii) osteomyelitis/septic arthritis; iii)
undrainable/undrained abscess; iv) unremovable/unremoved prosthetic-associated
infection (e.g. infected pacemaker, prosthetic joint infection, ventriculoperitoneal
shunt infection etc.) (note: central venous catheters, including tunneled central
intravenous catheter, and urinary catheters are not excluded unless the treating
clinical team does not have equipoise for enrollment and randomization to either
group)

5. Patient has a single positive blood culture with a common contaminant organism
according to Clinical Laboratory & Standards Institute (CLSI) Guidelines: coagulase
negative staphylococci; or Bacillus spp.; or Corynebacterium spp.; or
Propionobacterium spp.; or Aerococcus spp.; or Micrococcus spp.

6. Patient has a positive blood culture with Staphylococcus aureus or Staphylococcus
lugdunensis

7. Patient has a positive blood culture with Candida spp. or other fungal species.

8. Blood culture grows rare bacterial pathogens requiring prolonged treatment (e.g.
Mycobacteria spp., Nocardia spp., Actinomyces spp., Brucella spp., Burkholderia
pseudomallei)