Breakpoints #108 – IDWeek 2024 Recap: Late Breaker Abstracts and Stewardship Talks
Dec 20, 2024
The hosts enthusiastically recap highlights from ID Week 2024, focusing on crucial findings like optimal antibiotic durations for bloodstream infections. They explore groundbreaking trials on maternal microbiome impacts on infant health and innovations in pediatric RSV prevention. A lively discussion on enhancing diversity in antimicrobial stewardship education showcases a successful program. Finally, the panel shares humorous moments from the conference, making it clear that science and laughter go hand-in-hand in advancing infectious disease practices.
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Seven Days Is Often Enough For Bacteremia
- The BALANCE randomized trial showed 7 days of adequate antibiotics was non-inferior to 14 days for most hospitalized bacteremia patients.
- Shorter planned durations increased antibiotic-free days without increasing 90-day mortality or major harms.
Lower Rifampin Dose Matches Efficacy, Less Toxicity
- The EVRIOS trial found low-dose rifampin (10 mg/kg/day) non-inferior to high-dose (20 mg/kg/day) when combined primarily with fluoroquinolones for staphylococcal bone and joint infections.
- High-dose rifampin produced significantly more serious adverse reactions, favoring lower dosing to reduce toxicity.
DOOR Creates A Single Patient-Centered Endpoint
- DOOR (Desirability of Outcome Ranking) combines benefits and harms into one ordinal patient-centered endpoint for antibiotic trials.
- DOOR can obscure individual outcomes like mortality, so reviewers should also inspect component breakdowns and co-primary outcomes.