Key Points

  • There are no randomized clinical trials to support specific recommendations for the duration of therapy for device-related infections.
  • Patients with catheter-related bacteremia should be separated into those with complicated infections in which there is septic thrombosis, endocarditis, osteomyelitis, or possible metastatic seeding that require longer courses of therapy versus those with uncomplicated bacteremia that can be treated for shorter periods (120).
  • If there is a prompt response to initial antibiotic therapy, most patients with uncomplicated bacteremia who are not immunocompromised and without underlying heart disease or a prosthetic device should receive 10 to 14 days of antimicrobial therapy of Gram-negative bacilli and at least 14 days for S. aureus. Coagulase-negative staphylococci needs to be treated for only seven days, if the device is removed (120).
  • Patients with tunnel infection or abscess require removal of the catheter and 7 to 10 days of antibiotic therapy.

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