7 Days Noninferior in Bacteremia - Summary - MDSpire
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7 Days Noninferior in Bacteremia

BALANCE compared 7 vs 14 days of treatment among hospitalized patients with bloodstream infections.

  • By

  • Kathryn Wighton

  • May 12, 2026

  • 5 min

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Objective:

To evaluate the noninferiority of 7 days versus 14 days of adequate antibiotic treatment in hospitalized patients with bloodstream infections.

Key Findings:
  • 15% mortality in the 7-day group vs. 16% in the 14-day group by 90 days.
  • Per-protocol analysis showed 13% mortality in the 7-day group vs. 15% in the 14-day group.
  • Patients assigned to 7 days had a median of 19 antibiotic-free days by day 28.
Interpretation:

The study supports shorter antibiotic courses in critically ill populations without compromising patient outcomes.

Limitations:
  • Open-label design and protocol nonadherence with 23.1% of 7-day and 10.7% of 14-day patients receiving longer treatment.
  • Underpowered to determine benefits of longer treatment in selected patient populations.
  • Exclusions of certain infections and conditions limit generalizability.
Conclusion:

Shorter antibiotic treatment durations can be effective, supporting antibiotic stewardship efforts and reducing drug exposure and costs.

Original Source(s)

7 Days Noninferior in Bacteremia

  • by Kathryn Wighton

  • May 12, 2026

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