JAMA Netw Open

Uncomplicated gram-negative bacteremia: Is it safe to switch early to oral antibiotics?

January 30, 2024

Early transition to oral antibiotics was associated with 90-day all-cause mortality risk comparable to that of continuing IV antibiotic treatment and may be an effective alternative.

• This cohort study included observational data from adults with uncomplicated gram-negative bacteremia in 4 hospitals in Copenhagen, Denmark.
• A total of 914 individuals were included in the target trial emulation analysis (median age, 74.5 years); 433 (47.4%) transitioned early to oral antibiotic treatment, and 481 (52.6%) received prolonged IV treatment.
• Ninety-nine individuals (10.8%) died during follow-up. The proportion of individuals who died was higher in the group receiving prolonged IV treatment (69 [14.3%] vs. 30 [6.9%]). In the intention-to-treat analysis, 90-day all-cause mortality risk was 9.1% (95% CI, 6.7%-11.6%) for the early-switch group and 11.7% (95% CI, 9.6%-13.8%) for the group receiving prolonged IV treatment; the risk difference (RD) was -2.5% (95% CI, -5.7% to 0.7%) and risk ratio (RR) was 0.78 (95% CI, 0.60-1.10). In the per-protocol analysis, the RD was -0.1% (95% CI, -3.4% to 3.1%) and RR was 0.99 (95% CI, 0.70-1.40).

Source:

Tingsgård, S. et al. (2024, January 4). JAMA Netw Open. Early Switch From Intravenous to Oral Antibiotics for Patients With Uncomplicated Gram-Negative Bacteremia. https://pubmed.ncbi.nlm.nih.gov/38261322/