Effectiveness of oral antibiotics for definitive therapy of Gram-negative bloodstream infections

A Systematic Review and Meta-analysis of Antibiotic Treatment Duration for Bacteremia Due to Enterobacteriaceae

“…Third, the impact of treatment duration on outcomes may depend on the type of antibiotic used; however, data on the specific antibiotics used were not provided in the included studies. Interestingly, according to a previously published study which assessed the effectiveness of oral antibiotics in the treatment of Gram-negative bacteremia, clinical outcomes improve with oral antibiotics of high bioavailability compared to outcomes with antibiotics of moderate or low bioavailability (such as cephalosporins or penicillins) (36).…”

Intravenous‐only or Intravenous Transitioned to Oral Antimicrobials for Enterobacteriaceae‐Associated Bacteremic Urinary Tract Infection

“…In light of these limitations, similar results in a larger study population to corroborate the findings of this study and elucidate risk factors for failure would further enhance clinical decision‐making. A publication on the effectiveness of PO antibiotics in the treatment of gram‐negative bloodstream infections included 70.2% patients with bacteremia from a urinary source and found that antibiotics with high bioavailability had a lower rate of failure than antibiotics of moderate or low bioavailability . However, the evidence that PO therapy can be used successfully to complete the treatment course for Enterobacteriaceae bacteremic UTI, coupled with the potential for reducing costs with shorter LOSs and fewer hospital days on antibiotics, provides a foundation for use of PO antibiotics in this situation.…”

Top Questions in Uncomplicated, Non–Staphylococcus aureus Bacteremia

“…Clinical success rates were equivalent when comparing oral beta-lactams (86.9%) with fluoroquinolones (87.1%; odds ratio [OR], 1.24; 95% confidence interval [CI], 0.57–2.71) and when intravenous to oral switch occurred within the first 3 days vs later [ 47 ]. Kutob and colleagues compared definitive therapy with antibiotics categorized as low (ie, oral beta-lactams, n = 77), moderate (ie, ciprofloxacin, trimethoprim-sulfamethoxazole, n = 179), or high bioavailability (ie, levofloxacin, n = 106) [ 48 ]. Failure occurred in 14% of the low, 12% of the moderate, and 2% of the high bioavailability.…”