Shorter Antibiotic Therapy for Immunocompromised Patients with Bacteremia

Patients with non–Staphylococcus aureus bloodstream infections are increasingly treated with 7 days of antibiotic therapy instead of 14, based in part on the randomized, 3600-patient BALANCE trial. To examine whether this shorter course of therapy is sufficient for immunocompromised patients, BALANCE investigators conducted a post hoc analysis of the 1037 trial participants with immune compromise (median age, 72).

Solid malignancy was the main reason for immune compromise (75%), followed by chemotherapy and hematologic malignancy; only 5% of patients were taking corticosteroids, and 2% had HIV. The trial excluded patients with neutropenia, prior transplantation, S. aureus bacteremia, or other infections requiring prolonged therapy (e.…