Table 2.
Observational studies on antibiotic duration for BSI
| Study | N | Design | Short | Long | Outcome | Resistance | Key finding |
|---|---|---|---|---|---|---|---|
| Chotiprasitsakul (2018) [20] | 770 | Retrospective, PS-matched, multicenter | 6–10 d | 11–16 d | 30—d mortality | Not stratified | No difference, HR 1.12 (0.70–1.80); trend toward less MDRGN emergence |
| Giannella (2018) [11] | 856 | Retrospective, single-center | ≤ 10 d | > 10 d | 90—d mortality | E. coli (not stratified) | No excess mortality or relapse |
| Nelson (2017) [19] | 411 | Retrospective, PS-adjusted | 7–10 d | > 10 d | 90—d failure | Not reported | 13.2% (short) vs 8.5% (long) |
| Sousa (2019) [9] | 395 | Prospective, PS-stratified | 7–10 d | > 10 d | 30—d mortality | 14% ESBL, 4% CPE | No difference in general population |
| McAteer (2023) [10] | 1,099 | Retrospective cohort, multicenter | 7 or 10 d | 14 d | 30—d recurrence | 13% ESBL, 1% CPE | aOR 0.99 (95% CI 0.52–1.87) |
| Tingsgård (2024) [21] | 1,040 | Target trial emulation, multicenter | 5–7 d | > 7 d | 90—d mortality | 0.4% ESBL | No difference |
| Tingsgård (2024) [22] | 914 | Target trial emulation, multicenter | IV → oral ≤ 4 d | IV ≥ 5 d | 90—d mortality | 10.9% ciprofloxacin-resistant | Early switch comparable (RR 0.78; 0.60–1.10) |
| Zuercher (2023) [23] | 382 | Retrospective cohort, multicenter | ≤ 10 d | > 10 d | Time to discharge/death | Mixed (not stratified) | No benefit of longer therapy |
| Le Berre (2025) [12] | 379 | Retrospective cohort, multicenter | ≤ 7 d | > 7 d | Mortality | 100% ESBL-E | HR 1.65 (0.91–3.00) |
| Soto (2024) [13] | 183 | Retrospective, PS-weighted, multicenter | 7–10 d | 14–21 d | 30—d composite | 100% CRE | OR 1.21 (0.55–2.31) |
| Bahrs (2023) [25] | 219 | Retrospective, multicenter, IPTW | ≤ 9 d | ≥ 10 d | 30—d mortality | 100% VRE | OR 1.15 (p = 0.773); shorter hospital stay |
| Abbas (2020) [26] | 530 | Retrospective cohort, single-center | ≤ 14 d | > 14 d | 90—d mortality | 17.7% MRSA | aHR 0.32 for > 14 d in complicated SAB; aHR 0.85 (0.41–1.78) uncomplicated SAB |
| Evans (2023) [27] | 587 | Retrospective, cloning approach | ≤ 10 d | > 10 d | 28—d in-hospital mortality | 15.7% MRSA | HR 1.74 (1.36–2.24) for short therapy; no significant interaction by methicillin susceptibility (P = 0.12) |
| Torres (2025) [31] | 48 | Retrospective, single-center | ≤ 6 d | > 6 d | 30—d recurrence | 100% VRE | No recurrences; mortality 30% vs 21.1% (p = 0.41) |
| Gajdos (2025) [24] | 550 | Prospective cohort, multicenter, IPTW | 7–10 d | 14–21 d | 28—d treatment failure | 17% DTR-GN (short); 36.6% DTR-GN (long) | OR 0.64 (0.44–0.93) |
PS, propensity score; d, days; DTR-GN, difficult-to-treat Gram-negative; SAB, S. aureus bacteremia; IPTW, inverse probability of treatment weighting