Topics:
Infectious Disease • General Infectious Disease
Is there a role for beta-lactams as step-down oral therapy for uncomplicated gram-negative bacteremia?
If so, what antibiotic regimens do you use?
Answer from: at Academic Institution
For carefully selected patients - yes. Patients who might be good candidates for transition to oral beta-lactams for uncomplicated gram-negative bacteremia would-be patients:
clinically stable, improving on IV abx
with functioning GI tracts (no issues with absorption of antibiotics)
not immunocom...
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Answer from: at Community Practice
Agree with Dr. @Bartley, most often for urosepsis, once source control is achieved.
Answer from: at Academic Institution
Agree with Dr. @Marks. It has been our practice to do this for many years and, to the best of our knowledge, there has not been any obvious downside and we have spared people quinolones or TMP Sulfa in older patients on ARB/ACE-I. Some data would suggest higher relapse rates but I think that can be ...
Answer from: at Academic Institution
Agree with Dr. @Marks. I also will base in source of bacteremia, since majority are kidney (source control/stone/obstruction) before switch to oral.
Answer from: at Community Practice
How about for Renal stones causing pyelonephritis and Bacteremia, Urology performs stent placement? Oral ok?
Comments
at HCA Houston Healthcare Tomball
Yes, but once the patient is asymptomatic for at l...
Yes, but once the patient is asymptomatic for at l...
at Southwest Infectious Disease Associates
Thank you.
Thank you.
Answer from: at Community Practice
I agree, when there is a urinary source. the data are better than they were in a way. Cephalexin has done "better" in this setting, assuming of course the GNR isolate is susceptible.
A problem I have noticed can be found in this question. GNR bacteremia is not like SAB or candidemia, yet, for years...