Early Transition to Oral Antibiotics Improves Gram-Negative Bacteremia Outcomes

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-01-27T12:00:07+05:30 | Updated On 27 Jan 2024 2:18 PM IST

A recent study conducted in Copenhagen, Denmark, found promise for gram-negative bacteremia which has seen a critical development in the optimization of the transition from intravenous (IV) to oral antibiotics within four days of the initial blood culture. The findings of the study were published in the Journal of American Medical Association.

The study utilized observational data from four hospitals in Copenhagen from January 1, 2018 yo December 31, 2021 and focused on adults with uncomplicated gram-negative bacteremia. The eligibility criteria included positive blood cultures, clinical stability within four days of the initial culture, availability of susceptibility reports on day 4 and the initiation of appropriate empirical IV antibiotic treatment within 24 hours of the blood culture.

Out of the 914 individuals included in the study, 47.4% transitioned early to the oral antibiotic treatment, while 52.6% received prolonged IV treatment. 90-day all-cause mortality was significantly lower in the early-switch group (6.9%) when compared to the group receiving prolonged IV treatment (14.3%).

The main outcome of the study found early transition to oral antibiotics within four days of the initial blood culture that showed a 90-day all-cause mortality risk comparable to that of continuing IV antibiotic treatment. The risk difference was -2.5% which indicating a lower risk in the early-switch group, despite not statistically significant. The analysis further solidified the findings observed, with a negligible risk difference of -0.1%.

This research utilized the target trial emulation framework that challenge the conventional wisdom in treating gram-negative bacteremia. The findings suggest that the timely transition to oral antibiotics could be an effective alternative to prolonged IV treatment that can promise improved patient outcomes and more efficient resource utilization.

Reference:

Tingsgård, S., Bastrup Israelsen, S., Jørgensen, H. L., Østergaard, C., & Benfield, T. (2024). Early switch from intravenous to oral antibiotics for patients with uncomplicated gram-negative bacteremia. JAMA Network Open, 7(1), e2352314. https://doi.org/10.1001/jamanetworkopen.2023.52314

JAMA Network OpenGram-negative bacteremiaintravenous-to-oral antibiotic switch

Source : JAMA Network Open

Jacinthlyn Sylvia

Neuroscience Masters graduate

Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751