Staphylococcal Bacteremia in Cancer Patients

Dn, Carney; Rh, Parker; Be, Fossieck

doi:10.1097/00007611-198202000-00006

Cited by 1 publication

(1 citation statement)

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“…Oral treatment for staphylococcal bacteremia is not a novel concept. Carney et al reported a series of 18 oncology patients with staphylococcal bacteremia who were switched to oral dicloxacillin or cefalexin 1 g qid after a mean of 9-day IV therapy from as early as the 1980s, resulting in clinical and bacteriological cure in all cases except 1 [59]. Several retrospective studies have been published data about safety and efficacy of oral step-down in patients with bacteremia from S. aureus.…”

Section: Gram-positive Bacteremia S Aureus Bacteremia: Clinical Effic...mentioning

confidence: 99%

Oral Antibiotics for Bacteremia and Infective Endocarditis: Current Evidence and Future Perspectives

Eleftheriotis,

Marangos,

Lagadinou

et al. 2023

Microorganisms

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Bacteremia and endocarditis are two clinical syndromes that, for decades, were managed exclusively with parenteral antimicrobials, irrespective of a given patient’s clinical condition, causative pathogen, or its antibiotic susceptibility profile. This clinical approach, however, was based on low-quality data and outdated expert opinions. When a patient’s condition has improved, gastrointestinal absorption is not compromised, and an oral antibiotic regimen reaching adequate serum concentrations is available, a switch to oral antibacterials can be applied. Although available evidence has reduced the timing of the oral switch in bacteremia to three days/until clinical improvement, there are only scarce data regarding less than 10-day intravenous antibiotic therapy in endocarditis. Many standard or studied oral antimicrobial dosages are smaller than the approved doses for parenteral administration, which is a risk factor for treatment failure; in addition, the gastrointestinal barrier may affect drug bioavailability, especially when the causative pathogen has a minimum inhibitory concentration that is close to the susceptibility breakpoint. A considerable number of patients infected by such near-breakpoint strains may not be potential candidates for oral step-down therapy to non-highly bioavailable antibiotics like beta-lactams; different breakpoints should be determined for this setting. This review will focus on summarizing findings about pathogen-specific tailoring of oral step-down therapy for bacteremia and endocarditis, but will also present laboratory and clinical data about antibiotics such as beta-lactams, linezolid, and fosfomycin that should be studied more in order to elucidate their role and optimal dosage in this context.

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Section: Gram-positive Bacteremia S Aureus Bacteremia: Clinical Effic...mentioning

confidence: 99%