After catheter removal and first negative blood culture
- Coagulase-negative staphylococci without fever or endovascular material: 3 days
- Streptococci, enterococci, and Gram-negative bacilli (GNB): 7 days
- S. aureus: 14 days
- If septic thrombophlebitis: 21 days
- Yeasts: 14 days
If catheter preservation attempted (streptococci, enterococci, GNB, coagulase-negative staphylococci)
- Lock therapy PLUS systemic antibiotics: 10 days
Complete amputation without skin/soft tissue infection
- 48 hours post-op
Complete amputation with skin/soft tissue infection
- 7D post-op
Osteitis without amputation
- 6 weeks
Cholecystitis
- Perforated gallbladder or grade III: 3 days
- Percutaneously drained, untreated surgically, or undrained: 7 days
- Drained cholangitis: 3 days post-drainage
C. difficile infection
- 10 days
Diarrhea
Adults
- Traveler’s diarrhea: single dose OR 3D if fever or dysenteric syndrome
Children
- Shigella/Campylobacter: 3 days
- Yersinia: 5 days
- Salmonella (if treated): 5 days
Diverticulitis (after symptomatic treatment failure)
7 days
Infected ascitic fluid
- 5 days
Liver abscess
- 28 days
Peritonitis
Adults
- Digestive perforation operated within 24h: <1 days (surgical prophylaxis)
- Non-surgical appendicitis: 7 days
- Localized peritonitis: 3 days
- Generalized communautary peritonitis: 4 days
- Postoperative peritonitis: 8 days
Children
- At least 5 days
Typhoid fever
- Simple 7 days (fluoroquinolones) OR 5 days (azithromycin)
Enterococci
- Native valve: 2 weeks dual therapy THEN 2 weeks monotherapy
- Prosthetic valve: 2 weeks dual therapy THEN 2 weeks monotherapy
- Native or prosthetic valve: 2 weeks if vancomycin + gentamicin (14 days)
- Amoxicillin + ceftriaxone effective ONLY on Enterococcus faecalis (6 weeksfor this combination)
Streptococcus S (MIC ≤ 0.125 mg/L)
- Native valve: 2 weeks (dual therapy) or 4 weeks (monotherapy)
- Prosthetic valve: 6 weeks
Streptococcus I/R (MIC > 0.125 mg/L)
- Native valve: 2 weeks dual therapy then 2 weeks monotherapy
- Prosthetic valve: 2 weeks dual therapy then 4 weeks monotherapy
S. aureus
- Native valve: 4 weeks monotherapy
- Prosthetic valve: 2 weeks triple therapy using rifampicin then 4 weeks dual therapy
Without microbiological documentation or clinical orientation
- If hospitalized: Minimum 3 days, with discontinuation if no signs of severity AND the patient is stable AND afebrile for 48 hours AND under hospital observation for 24-48 hours (if neutropenia persists)
- If outpatient: Discontinue when neutrophil count (PNN) > 500/mm3 (expected to be less than 7 days)
With microbiological documentation or clinical orientation
- 7 days then discontinue if afebrile for more than 4 days, microbiological eradication and resolution of clinical signs of infection (adjust according to site/pathogen)
Arthritis
- S. aureus: 6 weeks
- Streptococci: 4 weeks
- Gonococcus: 7 days
Hand arthritis, post-inoculation
- Recent (<4 weeks): surgical washout, then 14 days
Spondylodiscitis
Adult
- 6 weeks
Children
- for septic arthritis: 14 days
- for osteomyelitis: 3 weeks
- for pelvic osteoarthritis, spondylodiscitis, and more severe osteoarthritis: 4 to 6 weeks
Brain abscess
- 6 weeks (3 weeks if drained)
Listeria meningitis
- 21 days
Meningococcal meningitis
- 5 days
Pediatric meningitis
- Group B Streptococcus: 14 days
- Haemophilus: 7 days
- E. coli: 21 days
Pneumococcal meningitis
- 10 days
Acute Otitis Media
Adults
- General: 5 days
- Exception:
Children
- Under 2 years: 10 days
Community-acquired acute pneumonia
- Including parapneumonic effusion
Adults
- If clinical improvement by day 3: 3 days
- If no clinical improvement by day 3 but at day 5: 5 days
- If no improvement at day 5 or hospitalized in ICU: 7 days
Chlidren
- 5 days
COPD Exacerbations
- 5 days
Healthcare-Associated Pneumonia or Ventilator-Associated Pneumonia
Except immunocompromised, empyema or abscess
- 7 days
Legionellosis
- General : 14 days (21 days if severe form or immunocompromised patient)
- Exception Azithromycin: 5 days
Pertussis
- Based on macrolide Azithromycin: 3 days
- Clarithromycin: 7 days
- Other macrolides: 14 days
Purulent pleural effusion (after final drainage)
Adults
- 15 days
Children
- 2 weeks until 4 or 6 weeks
Sinusitis
Adults
- Amoxicillin: 7 days
Children
- Amoxicillin : 10 days
Streptococcal Pharyngitis (GAS)
- Amoxicillin: 6 days
- Penicillin allergy (non-severe): Cefixime 4 days
- Severe beta-lactam allergy: Clarithromycin 5 days or Azithromycin 3 days
Complicated furuncle or animal bite
- 5 days
Furunculosis, severe impetigo, non-necrotizing bacterial dermo-hypodermitis (cellulitis, erysipelas, etc.)
- 7 days
GNB (Enterobacteriaceae, non-fermenters), streptococci, enterococci
- 7 days
S. aureus & S. lugdunensis
- 14 days
Complicated upper genital infections
- Ceftriaxone until improvement (max 7 days) + doxycycline AND metronidazole 14 days
Early syphilis
- Benzathine benzylpenicillin single dose
- If allergic: doxycycline 14 days
Uncomplicated upper genital infections
- Ceftriaxone until improvement (max 7 days) + doxycycline AND metronidazole 14 days
Urethritis and cervicitis
- Ceftriaxone single dose + doxycycline 7 days (alternative: + azithromycin 1g orally once)
Acute cystitis
Adults
- If Cotrimoxazole (based on antibiogramm) 5 days
- If other molecule (note: avoid fluoroquinolones) 7 days
Children
- If Cotrimoxazole (based on antibiogramm) 5 days
- If other molecule (note: avoid fluoroquinolones) 7 days
Acute pyelonephritis
Adults
- Fluoroquinolone or injectable beta-lactam: 7 days
- Other molecules, severe pyelonephritis, or with risk of complications, healthcare-associated: 10 days
Children
- 10 days
Male urinary tract infection with fever
- 14 days
Male urinary tract infection without fever
- 7 days