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SAB 14-Day Minimum — SCE Infectious Diseases MCQ

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EasyHealthcare-Associated InfectionsSAB 14-Day MinimumSCE Infectious Diseases

A 55-year-old man develops a hospital-acquired central line-associated bloodstream infection (CLABSI) with Staphylococcus aureus (MSSA). The line is removed. Blood cultures clear by day 2 on IV Flucloxacillin. TOE is normal (no endocarditis). He has no prosthetic material other than the removed line. What is the minimum antibiotic duration?

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Correct answer: E — At least 14 days from the first negative blood culture — uncomplicated S. aureus bacteraemia (SAB) requires a MINIMUM of 14 days of IV antibiotics even after line removal and culture clearance

S. aureus bacteraemia (SAB) ALWAYS requires at least 14 days of appropriate IV antibiotics — this is the minimum for UNCOMPLICATED SAB. Uncomplicated criteria (ALL must be met): (1) removed source (line), (2) blood cultures clearing within 72 hours, (3) no endocarditis on TOE, (4) no prosthetic material, (5) no metastatic infection, (6) no diabetes or immunosuppression as major risk factors. If ANY criterion is not met → COMPLICATED SAB → minimum 4–6 weeks of IV antibiotics. The 14-day minimum distinguishes SAB from other CoNS bacteraemias (which can be treated for 5–7 days).

Reference: BSAC 2023 – SAB guidelines; NICE NG139; IDSA 2009