Opening a DOOR for Pivotal Studies: An Example for Complicated Urinary Tract Infections

Article Pediatrics

Short- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children The SCOUT-CAP Randomized Clinical Trial

Derek J. Williams et al.

Summary: In a study among children with outpatient CAP, a 5-day antibiotic strategy was found to be superior to a 10-day strategy, resulting in similar clinical response and antibiotic-associated adverse effects, while reducing antibiotic exposure and resistance.

JAMA PEDIATRICS (2022)

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Article Infectious Diseases

Seven-versus 14-day course of antibiotics for the treatment of bloodstream infections by Enterobacterales: a randomized, controlled trial

Jose Molina et al.

Summary: This study demonstrates that 7-day courses of antibiotics can reduce patients' exposure to antibiotics while achieving similar clinical outcomes to 14-day courses for bloodstream infections caused by Enterobacterales. Although there is a possibility of relapsing fever in a limited number of patients, it does not impact the final outcomes.

CLINICAL MICROBIOLOGY AND INFECTION (2022)

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Article Infectious Diseases

Short- versus standard-course intravenous antibiotics for peri-prosthetic joint infections managed with debridement and implant retention: a randomised pilot trial using a desirability of outcome ranking (DOOR) endpoint

Laurens Manning et al.

Summary: This study investigated the optimal duration of intravenous antibiotics for peri-prosthetic joint infection (PJI). The findings suggest that shorter courses of IV antibiotics may be appropriate for selected patients with PJI managed with debridement and implant retention (DAIR). However, further confirmation is needed due to the small sample size and the data's alignment with other international trials.

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS (2022)

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Article Immunology

A Desirability of Outcome Ranking Analysis of a Randomized Clinical Trial Comparing Seven Versus Fourteen Days of Antibiotics for Uncomplicated Gram-Negative Bloodstream Infection

Jessica Howard-Anderson et al.

Summary: This study retrospectively evaluated the efficacy of short and conventional duration antibiotic therapy for Gram-negative bacterial bloodstream infection using a desirability of outcome ranking analysis. The results showed that short duration of antibiotics provided similar clinical outcomes as a conventional duration.

OPEN FORUM INFECTIOUS DISEASES (2022)

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Article Immunology

Desirability of Outcome Ranking for the Management of Antimicrobial Therapy (DOOR MAT): A Framework for Assessing Antibiotic Selection Strategies in the Presence of Drug Resistance

Brigid M. Wilson et al.

Summary: Antibiotic stewardship must consider effectiveness and spectrum of therapy, proposing the DOOR MAT approach for evaluating desirability of antibiotic selection. The principle is to effectively treat the patient while minimizing future resistance development.

CLINICAL INFECTIOUS DISEASES (2021)

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Article Microbiology

Propensity Score and Desirability of Outcome Ranking Analysis of Ertapenem for Treatment of Nonsevere Bacteremic Urinary Tract Infections Due to Extended-Spectrum-Beta-Lactamase-Producing Enterobacterales in Kidney Transplant Recipients

Belen Gutierrez-Gutierrez et al.

Summary: The efficacy of ertapenem in treating B-UTI caused by ESBL-E in KT recipients remains inconclusive, with similar clinical cure rates to meropenem. Ertapenem may offer some advantages in certain scenarios, as indicated by propensity score matching and DOOR analyses.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2021)

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Article Infectious Diseases