Length of hospital stay not affected by empirical treatment with ceftriaxone versus cefuroxime for bacteraemia

The preferred antibiotic treatment for bacteraemia in infants continues to be debated. We examined the duration of hospital stays as a surrogate for the effectiveness of initial treatment with ceftriaxone versus cefuroxime. This was a retrospective review of the medical records of all infants aged 3-36 months, admitted with suspected occult bacteraemia to the paediatric department at Laniado Hospital, Israel, between 2016 and 2022. The effect of antibiotic treatment, namely ceftriaxone versus cefuroxime, on hospital stays was determined, in both the total study population and population subgroups. We identified 217 patients (59.0% male) with a median age of 13 months and 12.4% had positive blood cultures. Approximately three-quarters (75.6%) received cefuroxime as their initial treatment for bacteraemia and the other quarter (24.4%) received ceftriaxone. The median length of hospital stay was 3.0 (interquartile range 3.0-4.0), with no statistically significant difference between the two drugs. However, we did notice a statistically significant shorter median length of hospital stay among fully vaccinated infants treated with cefuroxime rather than ceftriaxone (p = 0.055). The length of hospital stay among infants diagnosed with bacteraemia was not affected by whether they initially received ceftriaxone or cefuroxime. Further studies in larger populations are needed.