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Fluoroquinolone drugs are frequently employed as oral step-down therapy in patients with streptococcal bacteremia because of their favorable dosing intervals and excellent oral bioavailability compared with β-lactam antibiotics. Safety concerns with fluoroquinolone use, including tendon rupture, aortic rupture, QT prolongation, Clostridioides difficile diarrhea, and glycemic dysregulation, have caused reconsideration of these pharmacologic advantages. However, some studies showed higher treatment failure with β-lactams than fluoroquinolones as stepdown agents for gram-negative blood stream infection (BSI). To reexamine this issue, researchers retrospectively compared adult patients (mean age, 64 years) with streptococcal bacteremia, 133 of …