A study published in JAMA Internal Medicine examined whether switching to oral antibiotic therapy can effectively treat Enterobacteriaceae bloodstream infections.
Researchers conducted a retrospective multicenter cohort study, which included 4,967 patients hospitalized with monomicrobial Enterobacteriaceae bloodstream infection at three hospitals from Jan. 1, 2008, through Dec. 31, 2014. They performed 1:1 propensity-score matching that resulted in a cohort of 1,478 patients, of which 739 received oral step-down therapy within the first five days of treatment, while the rest received continued parenteral therapy.
The study shows that sources of Enterobacteriaceae bacteremia included urine, gastrointestinal tract, central line-associated, pulmonary, and skin and soft tissue.
There were 97 deaths in the oral step-down group and 99 in the parenteral therapy group within 30 days. There were no differences in bacteremia recurrence within 30 days between the groups.
However, patients who transitioned to oral step-down therapy were discharged from the hospital at an average of two days sooner than patients in the other group.
"The findings suggest that transitioning to oral step-down therapy may be an effective treatment approach for patients with Enterobacteriaceae bacteremia who have received source control and demonstrated an appropriate clinical response," study authors concluded.