Lay summary
Bloodstream infections caused by Gram-negative bacteria (e.g. gut bacteria) are common in Aotearoa New Zealand and can be life-threatening. These infections are usually treated with antibiotics, but using antibiotics that are too broad or for too long can lead to antibiotic resistance, making future infections harder to treat. Our study, a clinical trial called ‘BALANCE+’, aims to find the safest and most effective ways to use antibiotics in hospitalised adults with Gram-negative bloodstream infections. We will compare different treatment approaches, such as when to switch from broad to targeted antibiotics, which antibiotics taken by mouth are best, and which antibiotic to use for certain bacteria. We will check what effect the antibiotics used have on the healthy bacteria in the gut and we will explore patient and whānau views to identify what outcomes are important to address. The results of our study will improve patient treatment and reduce antibiotic resistance.