A US-based study on gram-negative bloodstream infections (GN-BSIs) revealed that less than 50% were shifted from intravenous (IV) to oral antibiotics, indicating a potential for improved antibiotic stewardship.

Johns Hopkins University and Trinity Health researchers assessed records of 4,581 GN-BSI cases in 24 US hospitals in 2019.

Only 43% were shifted to oral therapy by day 7, despite 90% achieving clinical stability by day 5.

Hospitals showed varied transition rates (25.8% to 65.9%).

The most prevalent infections were E. Coli urinary tract infections (60.4%).

Extended-spectrum beta-lactamase infections were more common in the IV group.

Oral therapy had a shorter duration (median 11 vs. 13 days), with fluoroquinolones prescribed the most (62.2%).

The authors suggested opportunities for early oral changeover and advocated targeted education for antimicrobial stewardship teams.