#121 – Finding BALANCE in Antibiotic Durations: The BALANCE Trial

In this second-ever collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Angela Huttner invite the two principal investigators and visionaries who spearheaded the Bacteremia Antibiotic Length Actually Needed for Clinical Effectiveness (BALANCE) trial, Nick Daneman and Rob Fowler from Sunnybrook Health Sciences Centre in Toronto, for a “deep dive into all things that went into this trial.” The BALANCE trial spanned over ten years investigating - as the acronym title suggests - whether a shorter treatment duration of seven days was non-inferior to the standard of care of fourteen days for bacteremia. The conversation covers everything from the initial hallway discussions that sparked the trial, the trial itself that screened over 36,000 patients and enrolled +3,600, its impact on clinical practice, key takeaways, and what’s next for Daneman and Fowler. References: BALANCE Investigators, et al. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. N Engl J Med. 2025 March. DOI: https://doi.org/10.1056/NEJMoa2404991