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

摘要: There is paucity of data evaluating intravenous-to-oral antibiotic switch options for Gram-negative bloodstream infections (BSIs). This retrospective cohort study examined the effectiveness oral antibiotics definitive treatment BSI. Patients with BSI hospitalised <14 days at Palmetto Health Hospitals in Columbia, SC, from 1 January 2010 through 31 December 2013 and discharged on were included this study. The was stratified into three groups based bioavailability prescribed (high, ≥95%; moderate, 75-94%; low, <75%). Kaplan-Meier analysis multivariate Cox proportional hazards regression used to examine failure. Among 362 patients, high, moderate low 106, 179 77 respectively, therapy Mean patient age 63 years, 217 (59.9%) women 254 (70.2%) had a urinary source infection. Treatment failure rates 2%, 12% 14% patients receiving bioavailability, respectively (P = 0.02). Risk model higher [adjusted hazard ratio (aHR) = 5.9, 95% CI 1.6-38.5; P = 0.005] (aHR = 7.7, 1.9-51.5; P = 0.003) compared those antimicrobial agents high bioavailability. These demonstrate increases as regimen declines.