Gram-Positive Bacteremia: Transitioning to Oral Therapy

Patients with gram-positive bloodstream infections are often treated with prolonged intravenous (IV) antibiotics, but growing evidence supports oral step-down therapy (Figure 1). Cefadroxil, a first-generation cephalosporin, has emerged as an option for such therapy because of its bioavailability, longer half-life, and twice-daily dosing.

In this retrospective, multicenter cohort, researchers analyzed 323 patients with bloodstream infections caused by methicillin-susceptible Staphylococcus aureus, S. lugdunensis, or Streptococcus species. The analysis excluded patients with high-risk infections (endocarditis, vertebral osteomyelitis, or prosthetic or central nervous system infections) or hemodialysis dependence. Of the 323 patients in…