Optimal management of BSI includes appropriate antimicrobial therapy as well as adequate source control (relief of urinary or biliary obstruction, removal of infected central venous catheters, drainage of intra-abdominal, pelvic, or deep tissue abscesses, etc.)
Empiric Antimicrobial Therapy
Intensive care unit admission
High acute severity of illness score (Pitt bacteremia score ≥4)
Relatively high predicted mortality (BSI risk score ≥5)
Occurring ≥48 hours after hospital admission
Prior hospitalization for ≥2 days in the past 90 days
Residence in nursing home or extended care facility
Home infusion therapy (chemotherapy, intravenous antibiotics, etc.)
Home wound care within 30 days
Nimmich E, et al. Hosp Pharm 2017
- Yahav D, et al. Seven versus fourteen days of antibiotic therapy for uncomplicated gram-negative bacteremia: A non-inferiority randomized controlled trial. Clin Infect Dis 2018. doi: 10.1093/cid/ciy1054. [Epub ahead of print]
- Nelson AN, et al. Optimal duration of antimicrobial therapy for uncomplicated gram-negative bloodstream infections. Infection 2017; 45: 613-20.
- Al-Hasan MN, et al. Reply to comments: Duration of antimicrobial therapy for gram-negative bacteremia secondary to urinary source of infection. Infection 2018; 46: 283-4.
- Rac H, et al. Evaluation of early clinical failure criteria for gram-negative bloodstream infections. Open Forum Infect Dis 2018; 5 (Suppl 1): S311-2.