Seven Versus 14 Days of Antibiotic Therapy for Multidrug-resistant Gram-negative Bacilli Infections

Inclusion criteria

• Infection's diagnosis while in the ICU

• Severe infection in any site (defined as the presence of sepsis/septic shock or bloodstream infection or pneumonia) associated with a positive culture by MRD-GNB (Acinetobacter baumannii complex, Pseudomonas aeruginosa, and Enterobacterales bacteria, only susceptible to carbapenems and/or polymyxins)

• Hemodynamically stable and afebrile (axillary temperature less than 37.8ºC) for at least 48 hours on day 7 of adequate antibiotic therapy

• Consent of the team providing care to the patient regarding their inclusion in the research

Exclusion criteria

• Inclusion in other experimental studies involving antimicrobial therapy

• Infections that have as the primary site: endocarditis/endovascular infection, necrotizing fasciitis, osteomyelitis, abdominal abscess or other abdominal infections requiring surgical intervention (except infections that have been treated surgically, with curative character within the first 3 days of appropriate antimicrobial therapy), central nervous system Infections, empyema, prosthetic infection;

• Immunosuppression defined as: neutrophil cells <1000/mm³ in the current hospitalization, HIV/AIDS diagnosis with last CD4 count <200/mm³, solid organ transplantation in the last year and/or need for increased immunosuppression due to acute rejection in the last year, hematopoietic stem cell transplantation in the last year, and/or current therapy for chronic graft-versus-host disease

• Positive blood cultures for the same pathogen within 48 hours prior to randomization, when collected

• Uncontrolled concomitant infection with another GNB (regardless of susceptibility profile)

• Previous inclusion in this study

• Known pregnancy

• Patient in palliative care who has already decided not to restart antimicrobials, if necessary, or hemodynamic support measures.