Bloodstream infections traditionally are treated with intravenous (IV) therapy. This study's purpose is to evaluate if oral step-down therapy is noninferior to IV therapy for gram-positive bloodstream infections (GP-BSIs). This retrospective cohort study included patients who received IV therapy and those who received oral step-down therapy for a nonstaphylococcal GP-BSI from 2017 to 2019. The primary endpoint was a composite outcome of 90-day all-cause mortality and clinical failure. A total of 308 patients were included (n = 94, oral; n = 214, IV). The oral step-down group had a lower incidence of 90-day clinical failure (9% vs 14%; P < 0.001). The IV group had a longer hospital stay (4 vs 6 days, P < 0.001); however, there were no significant differences in secondary outcomes. Bivariate analysis found no predictors of 90-day clinical failure. Oral step-down therapy was found to be noninferior to IV therapy.
CITATION STYLE
Gandhi, K., Wrzesinski, M., Bunnell, K., & Gibble, A. (2023). Oral antibiotic step-down therapy for nonstaphylococcal gram-positive bloodstream infections. Diagnostic Microbiology and Infectious Disease, 107(4). https://doi.org/10.1016/j.diagmicrobio.2023.116068
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