Clinical checklist can cut patient's time on antibiotics for staph infections, researchers find

Physicians shortened antibiotic duration for patients with uncomplicated staphylococcal bloodstream infections by about two days using a clinical checklist to identify eligible patients, a study published in JAMA found.

The study, conducted by researchers at Durham, N.C.-based Duke Health, tested an algorithm that defines how long patients with staph bloodstream infections should get IV antibiotics. The study included 509 patients with staph bloodstream infections at 16 medical centers in the U.S. and Spain.

The algorithm stems from several clinical characteristics that help physicians determine the infection's severity, including how long the patient has had a fever and blood culture results.

About half of the patients were randomly assigned to the algorithm-guided duration of antibiotics. Physicians determined the duration of the remaining patients' antibiotic treatment based on standard practice.

Patients in both groups recovered at the same rate, with 82 percent of the algorithm patients and 81.5 percent of the standard care patients having positive outcomes.

Complication rates were also statistically similar, but the study found a significant difference in antibiotic duration among patients with simple and uncomplicated infections, or those in which infection had not spread to other parts of the body.

For these patients, the algorithm treatment plan let physicians stop IV antibiotics about two days sooner than similar patients receiving standard care (4.4 days versus 6.2 days). 

"Any reductions in the use of antibiotics to treat these infections would be a significant benefit in our effort to fight antibiotic resistance, particularly when these measures can be undertaken without harm to patients," said lead study author Thomas Holland, MD.

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