Short Versus Long Duration of Therapy for Streptococcus Pneumoniae Bloodstream Infections

The Infectious Diseases Society of America (IDSA) guidelines for CAP management advocate for short courses of antibiotics for CAP treatment. However, it does not address duration of therapy for common CAP pathogens such as S. pneumoniae when associated with blood stream infections (BSI). 3

Currently, GP bacteremia duration of therapy typically ranges from 7 to 14 days based on IDSA guideline recommendations for Staphylococcus aureus bacteremia with no further definitive consensus.4 Additionally, lack of data and randomized clinical trials on the efficacy and safety of short compared to long treatment duration have led to variability in practice. Most randomized clinical trials as well as retrospective studies on treatment duration, have been conducted mainly in gram-negative BSI

Inclusion criteria

• • ≥18 years of age

• S. pneumoniae isolated from ≥1 blood cultures
• Active IV antibiotic therapy within 48 hours of the first positive blood culture(7,8)
• Clinical stability by day 10 of therapy

Exclusion criteria

• • Treatment duration <5 days or >16 days

• Death before completion of therapy (<10 days vs. ≥ 10 days )
• Polymicrobial BSI
• Invasive infection caused by S. pneumoniae (endocarditis, meningitis, and lung abscess)