INTRODUCTION

Uncomplicated bacteremia remains a leading cause of morbidity and mortality in hospitalized patients. Current guidelines recommend a minimum of 14 days of treatment.

OBJECTIVE

To evaluate the efficacy and safety of short usual antibiotic therapy in adults with uncomplicated . bacteremia (SAB).

METHODS

We developed a search strategy to identify systematic review and meta-analysis of non-randomized studies (NRS), comparing short usual or long antibiotic regimens for uncomplicated SAB in MEDLINE, Embase, and the Cochrane Register up to June 2023. The risk of bias was assessed using the ROBINS I tool. The meta-analysis was performed using Review Manager software with a random effect model.

RESULTS

Six NRS with a total of 1700 patients were included. No significant differences were found when comparing short prolonged antibiotic therapy as defined by the authors for 90-day mortality [odds ratio (OR): 1.09; 95% confidence interval (CI): 0.82-1.46, : 0.55;  = 0%] or 90-day recurrence or relapse of bacteremia [OR: 0.72; 95% CI: 0.31-1.68, : 0.45;  = 26%]. Sensitivity analysis showed similar results when comparing a predefined duration of <14 days ⩾14 days and when excluding the only study with a high risk of bias.

CONCLUSION

Shorter-duration regimens could be considered as an alternative option for uncomplicated SAB in low-risk cases. However, based on a small number of studies with significant methodological limitations and risk of bias, the benefits and harms of shorter regimens should be analyzed with caution. Randomized clinical trials are needed to determine the best approach regarding the optimal duration of therapy.