Gram-Negative Bacteremia: Another Candidate for Switching from Intravenous to Oral Treatment?

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…