An Update on Recent Clinical Trial Data in Bloodstream Infection
Stewart, Adam G. (The University of Queensland (Brisbane, Austràlia))
Simos, Peter (Gold Coast University Hospital (Austràlia))
Sivabalan, Pirathaban (Gosford Hospital (Austràlia))
Escolà-Vergé, Laura (Hospital Universitari Vall d'Hebron)
Garnham, Katherine (Gold Coast University Hospital (Austràlia))
Isler, Burcu (Princess Alexandra Hospital (Brisbane, Austràlia))

Fecha:	2024
Resumen:	Bloodstream infections (BSIs) remain a significant source of morbidity and mortality globally, exacerbated by an ageing population and rising antimicrobial resistance (AMR). This review offers an updated evaluation of randomized clinical trials (RCTs) in BSI management from 2018 onwards, focusing on the evolving landscape of diagnostics and treatment. New rapid diagnostic technologies and shorter antimicrobial courses have transformed clinical practice, reducing the time to appropriate therapy and hospital stays. Several RCTs demonstrated that rapid phenotypic and genotypic tests shorten the time to optimal therapy, especially when paired with antimicrobial stewardship. Ongoing trials are investigating novel antimicrobial regimens and the safety of early oral switch strategies, particularly for Gram-positive and Gram-negative BSIs. Recent RCTs on Staphylococcus aureus BSI (SAB) and multidrug-resistant Gram-negative bacteria highlight advances in treatment but emphasize the need for further study into the efficacy of combination therapies and the utility of rapid diagnostics in different healthcare settings. The review also explores challenges in trail design, with adaptive and pragmatic appropriates improving the efficacy of clinical trials. Finally, this paper identifies gaps in the research, including the need for further investigation into oral step-down therapy, optimal durations, and the role of rapid diagnostics in resource-limited settings.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Bacteraemia ; Bloodstream infection ; Clinical trial
Publicado en:	Antibiotics, Vol. 13 (november 2024) , ISSN 2079-6382

DOI: 10.3390/antibiotics13111035
PMID: 39596730

14 p, 299.9 KB

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