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In men with afebrile urinary tract infection (UTI), a 7-day course of antibiotics may be sufficient (NEJM JW Gen Med Sep 1 2021 and JAMA 2021 Jul 27; 326:324) — but what about a sicker population? In a noninferiority trial, investigators in France randomized men with febrile UTI to 7 or 14 days of antibiotics and evaluated treatment success at 6 weeks as defined by clinical success (lack of fever), microbiologic success (negative urine culture), and absence of subsequent antibiotics against the isolated uropathogen.
Among 240 participants (median age, 60.4) the most common uropathogen was Escherichia coli, and among 196 participants with blood cultures, results were positive in 17%. At baseline, certain comorbidities were more prevalent in t…