1. Intravenous-only or Intravenous Transitioned to Oral Antimicrobials for Enterobacteriaceae-Associated Bacteremic Urinary Tract Infection.
- Author
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Rieger KL, Bosso JA, MacVane SH, Temple Z, Wahlquist A, and Bohm N
- Subjects
- Administration, Intravenous, Administration, Oral, Aged, Bacteremia microbiology, Cohort Studies, Enterobacteriaceae drug effects, Enterobacteriaceae isolation & purification, Enterobacteriaceae Infections microbiology, Female, Hospitalization statistics & numerical data, Humans, Length of Stay, Male, Middle Aged, Retrospective Studies, Treatment Failure, Treatment Outcome, Urinary Tract Infections microbiology, Anti-Bacterial Agents administration & dosage, Bacteremia drug therapy, Enterobacteriaceae Infections drug therapy, Urinary Tract Infections drug therapy
- Abstract
Objectives: To characterize antibiotic regimens utilized for bacteremic Enterobacteriaceae urinary tract infections and assess treatment failure associated with intravenous-only compared to intravenous transitioned to oral antibiotic treatment., Design: Retrospective cohort., Settings: Tertiary care academic medical center., Patients: 241 adult patients hospitalized between July 1, 2010, and June 30, 2015, with positive blood and urine cultures with the same Enterobacteriaceae pathogen., Main Results: Hospital days on antibiotics as well as length of stay were less in the group treated with any oral antibiotics (intravenous/oral, median 5 [IQR 3-7] days vs intravenous-only antibiotics 6 [4-10] days, p<0.001; length of stay for intravenous/oral 4.6 [3.1-7.8] days vs intravenous-only 7.1 [4.0-17.5] days, p<0.001). No statistically significant difference was found in the composite outcome of treatment failure in patients who received intravenous-only antibiotics versus intravenous/oral antibiotics for the treatment of bacteremic urinary tract infections (intravenous-only 3.8% [95% CI: 1.0-9.4%] failure; intravenous/oral 8.2% [95% CI: 4.1-14.1%] failure; p=0.19)., Conclusions: Intravenous transitioned to oral treatment (intravenous/oral) was associated with a shorter length of stay and fewer hospital antibiotic days compared with intravenous-only therapy. Transitioning from intravenous to oral antibiotic therapy is a viable treatment option to consider for patients with bacteremic Enterobacteriaceae urinary tract infection., (© 2017 Pharmacotherapy Publications, Inc.)
- Published
- 2017
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