Oral Antibiotics Show Promise in Treating Uncomplicated Gram-Negative Bacteremia Post-Organ Transplant
A retrospective study published in the Clinical Infectious Diseases journal suggests that oral step-down therapy is effective and safe for managing uncomplicated gram-negative bacteremia in organ transplant recipients. The study, conducted by researchers from Massachusetts General and Brigham and Women’s Hospital over a five-year period, compared the outcomes of patients who switched to oral antibiotics with those who received full intravenous therapy.
The primary endpoints of the study, which were mortality, bacteremia recurrence, and restarting intravenous antibiotics, showed no significant differences between the two groups. However, patients who transitioned to oral antibiotics had a significantly shorter hospital stay, with an average reduction of 1.97 days (p = 0.005).
Moreover, the intravenous group had a substantially higher risk of complications. They had an 8.4 times greater chance of developing a Clostridioides difficile infection (p = 0.015) and a 6.4 times higher risk of other treatment-related complications (p = 0.002). Additionally, 55% of patients in the intravenous group required a tunneled central venous catheter. Despite these differences, the total duration of treatment did not vary between the groups.
This study adds to the evidence supporting the use of oral step-down therapy as an effective and safe alternative for managing certain types of bacteremia in post-transplant patients.
