Table 1. Clinical Classification of Bacteremia and Duration of Algorithm-Based Therapy.
| Definition | Duration of Therapy (Range), d |
|---|---|
| Staphylococcus aureus Bacteremia | |
| Uncomplicated | 14 (±2) |
| Intravascular catheter source of infection (if present) removed within 5 d | |
| Negative follow-up blood culture 24-72 h after initial positive culture | |
| Defervescence within 72 h of initial positive culture | |
| Echocardiogram without evidence of endocarditis | |
| No symptoms or signs of metastatic infection | |
| No indwelling intravascular prosthetic devices | |
| Complicated | 28-42 (±2) |
| Positive follow-up blood culture for S aureus, OR | |
| Persistent fever, OR | |
| Echocardiography with evidence of endocarditis, OR | |
| Symptoms or signs of metastatic infection | |
| Coagulase-negative Staphylococcal Bacteremia | |
| Simple | 0-3 (+1)a |
| Single blood culture positive for coagulase-negative staphylococci | |
| Negative follow-up blood culture | |
| No signs or symptoms of local infection at a catheter site | |
| No symptoms or signs of metastatic infection | |
| No indwelling intravascular prosthetic devices | |
| Uncomplicated | 5 (±1) |
| ≥2 blood cultures positive for coagulase-negative staphylococci drawn ≤24 h apart, OR | |
| Single blood culture positive for coagulase-negative staphylococci, PLUS symptoms or signs of infection at a catheter site | |
| Complicated | 7-28 (±2) |
| ≥2 blood cultures positive for coagulase-negative staphylococci from samples drawn >24 h apart, OR | |
| Echocardiography with evidence of endocarditis, OR | |
| Symptoms or signs of metastatic infection | |
a
For patients with simple coagulase-negative staphylococcal bacteremia, treatment was discontinued on randomization to algorithm-based therapy. Thus, if clinicians suspected that the positive culture result was attributable to contamination and had not initiated therapy, those patients did not receive any study antibiotic therapy.