Optimizing the Management of Uncomplicated Gram-Negative Bloodstream Infections: Consensus Guidance Using a Modified Delphi Process
AuthorHeil, Emily L
Bork, Jacqueline T
Abbo, Lilian M
Barlam, Tamar F
Cosgrove, Sara E
Ha, David R
Jenkins, Timothy C
Kaye, Keith S
Lewis, James S
Ortwine, Jessica K
Pogue, Jason M
Spivak, Emily S
Stevens, Michael P
Tamma, Pranita D
JournalOpen Forum Infectious Diseases
PublisherOxford University Press
MetadataShow full item record
AbstractBackground: Guidance on the recommended durations of antibiotic therapy, the use of oral antibiotic therapy, and the need for repeat blood cultures remain incomplete for gram-negative bloodstream infections. We convened a panel of infectious diseases specialists to develop a consensus definition of uncomplicated gram-negative bloodstream infections to assist clinicians with management decisions. Methods: Panelists, who were all blinded to the identity of other members of the panel, used a modified Delphi technique to develop a list of statements describing preferred management approaches for uncomplicated gram-negative bloodstream infections. Panelists provided level of agreement and feedback on consensus statements generated and refined them from the first round of open-ended questions through 3 subsequent rounds. Results: Thirteen infectious diseases specialists (7 physicians and 6 pharmacists) from across the United States participated in the consensus process. A definition of uncomplicated gram-negative bloodstream infection was developed. Considerations cited by panelists in determining if a bloodstream infection was uncomplicated included host immune status, response to therapy, organism identified, source of the bacteremia, and source control measures. For patients meeting this definition, panelists largely agreed that a duration of therapy of ~7 days, transitioning to oral antibiotic therapy, and forgoing repeat blood cultures, was reasonable. Conclusions: In the absence of professional guidelines for the management of uncomplicated gram-negative bloodstream infections, the consensus statements developed by a panel of infectious diseases specialists can provide guidance to practitioners for a common clinical scenario.
Rights/Terms© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/17083
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