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Switching from intravenous to oral antibiotic therapy can be as efficacious as continued IV treatment, even for infective endocarditis (NEJM JW Infect Dis Aug 28 2018 and N Engl J Med 2019; 380:415) or bone and joint infections (NEJM JW Infect Dis Jan 30 2019 and N Engl J Med 2019; 380:425), simplifying outpatient management. But what about gram-negative bacteremia, which is usually managed with a full course of IV antibiotics?
Researchers addressed this issue in a multicenter open-label, randomized trial involving 176 adults (mean age, 57) with gram-negative bloodstream infections. The source of bacteremia was most often the urinary tract (60%). Escherichia coli (67%) and Klebsiella spp. (24%) were the most prevalent pathogens. Of the teste…