Early Switch to Oral Antibiotics in Patients with Enterobacteriaceae Bacteremia

Patients with uncomplicated Enterobacteriaceae bacteremia that responds to initial therapy can likely be safely discharged to complete therapy with oral agents.

In treating gram-negative bacteremia, many clinicians have become comfortable transitioning to certain oral agents to complete therapy. Now, a retrospective case-control study provides support for that approach.

Investigators at three academic medical centers conducted a retrospective cohort study, matching 739 patients who received a prolonged intravenous course with patients who were “stepped down” to oral agents within 5 days (median, 3 days). Median total antibiotic course was 14 days in both groups. All patients demonstrated response to initial therapy and had adequate source control. Most infections (40%) had a urinary source, followed by gastrointestinal tract (20%), central line (18%), pulmonary (4%), and skin and soft tissue (3%).

Th…

Reviewing Author

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Early Switch to Oral Antibiotics in Patients with Enterobacteriaceae Bacteremia

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Reviewing Author