Seven days versus extended duration antibiotic therapy for multidrug-resistant gram-negative bacterial infections in critically ill patients: A pooled analysis of the OPTIMISE and REGARD-VAP trials
Authors' conclusion
Shorter regimens appear comparable to extended courses in critically ill patients, though potential relapse risk warrants further study.
Study context
- Population
- Critically ill ICU patients with multidrug-resistant gram-negative bacterial (Multidrug-resistant Gram-negative bacteria (MDR-GNB)) infections
- Participants
- 602 patients · 2 randomized controlled trials (RCTs)
- Comparison
- Short-course vs extended antibiotic therapy
- Outcome
- Composite of:
- Mortality and reinfection/recurrence
- Mortality
- Reinfection/recurrence
Methodological detailsrandom-effects models, pooled analysis of 2 RCTs
- Random-effects models
- Pooled analysis of 2 RCTs
Pooled result
As reported in the abstract
Short-course vs ExtendedOdds ratio (95 % CI)
Mortality; I2 = 18 %
0.74(0.45–1.23)
Clinical failure; I2 = 0 %
0.82(0.50–1.36)
Relapse, more often with short-course but not statistically significant; I2 = 22 %
2.04(0.85–4.92)
Original publication
Seven days versus extended duration antibiotic therapy for multidrug-resistant gram-negative bacterial infections in critically ill patients: A pooled analysis of the OPTIMISE and REGARD-VAP trials. J Crit Care. Published 29 November 2025. doi:10.
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