Clinical Research Directory

Inclusion Criteria: * Age \>18 years * Blood culture positive for Gram-negative bacteria * Evidence of urinary tract source of infection (positive urine culture or at least one clinical symptom compatible with urinary tract infection) * Antibiotic treatment with antimicrobial activity to Gram-negative bacteria administrated within 12 hours of first blood culture * Temperature \<37.8°C at randomization * Clinically stabile at randomization (systolic blood pressure \> 90 mm Hg, heart rate \<100 beats/min., respiratory rate \<24/minute, peripheral oxygen saturation \> 90 %) * Oral and written informed consent Exclusion Criteria: * Antibiotic treatment (\>2 day) with antimicrobial activity to Gram-negative bacteria within 14 days of inclusion * Gram-negative bacteremia within 30 days of blood culture * Immunosuppression (Untreated HIV-infection, Neutropenia (absolute neutrophil count \< 1.0 x 109/l), Untreated terminal cancer, Receiving immunosuppressive agents (ATC-code L04A), Corticosteroid treatment (≥20 mg/day prednisone or the equivalent for \>14 days) within the last 30 days, Chemotherapy within the last 30 days, Immunosuppressed after solid organ transplantation, Asplenia) * Polymicrobial growth in blood culture * Bacteremia with non-fermenting Gram-negative bacteria (Acinetobacter spp, Burkholderia spp, Pseudomonas spp), Brucella spp, or Fusobacterium spp * Failure to remove source of infection within 72 hours of first blood culture (e.g. change of catheter á demeure) * Pregnancy or breastfeeding