Variability of treatment duration for bacteraemia in the critically ill: a multinational survey

Objectives: No definitive evidence is available to inform 'best' antibiotic practice for treating bacteraemia in the critically ili patient, either in terms of duration of therapy, or the use of mono- versus combination therapy. W e therefore undertook a large-scale international survey to assess the variability of current practice. Methods: A questionnaire was sent to membership lists of national an d international intensive care societies. Results: Responses from 254 intensive care units in 34 countries revealed a w i de variation in antibiotic strategy forali types of bacteraemia, ranging from short course (~5 days) therapy with restricted-spectrum antibiotics, to long course (~1 O days) use of broad-spectrum combinations. Two factors were significantly associated with antibiotic prescribing practice, namely the country of origin (in those with ~10 responders) and the leve l of microbiologist and/or lnfectious dlseases specialist input. The greater the specialist input, the shorter the duration of therapy (P< 0.0001 ). Conc/usions: The wide variability in antibiotic prescribing patterns suggests an urgent need to produce high-quality evidence to identity optimal antibiotic prescribing policies for bacteraemia in the critically ili patient.