What is it about?
The use of oral antibiotics in patients with bloodstream infections, infective endocarditis, and osteomyelitis has been a hot topic in the literature lately. This narrative review summarizes and critically appraises the most recent studies on uncomplicated and complicated bloodstream infections including the PEOT and OVIVA trials.
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Why is it important?
Transition of patients from intravenous to oral antibiotics is an effective and feasible strategy in the majority of patients with uncomplicated and complicated bloodstream infections due to gram-negative bacteria, obligate anaerobic bacteria, and Candida species. The role of oral step down therapy in patients with gram-positive bloodstream infections is currently evolving.
Perspectives
The use of oral antibiotics in patients with bloodstream and other serious infections has become more popular than ever before. Thanks to the numerous well designed studies on this topic lately. This approach spares many patients from central line-associated complications. This narrative review highlights that not all oral agents are created equal. Oral agents with high bioavailability have the highest level of evidence and most frequent clinical experience in patients with bloodstream infections. Antibiotic concentration at the primary site of infection, likely adherence with an oral regimen based on tolerability, number of pills, and frequency of administration are important factors to consider when choosing oral antibiotics.
Prof. Majdi Al-Hasan
University of South Carolina School of Medicine
Read the Original
This page is a summary of: Transition from intravenous to oral antimicrobial therapy in patients with uncomplicated and complicated bloodstream infections, Clinical Microbiology and Infection, May 2019, Elsevier,
DOI: 10.1016/j.cmi.2019.05.012.
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