Early oral antimicrobial therapy noninferior to intravenous standard therapy for low-risk bloodstream infection
By Elana Gotkine HealthDay Reporter
FRIDAY, Jan. 26, 2024 (HealthDay News) — For patients with low-risk Staphylococcus aureus (S. aureus) bloodstream infection, early switch to oral antimicrobial therapy is noninferior to intravenous standard therapy, according to a study published online Jan. 17 in The Lancet Infectious Diseases.
Achim J. Kaasch, M.D., from Otto von Guericke University Magdeburg in Germany, and colleagues conducted an international, open-label, randomized, noninferiority trial conducted in 31 tertiary care hospitals involving patients with low-risk S. aureus bloodstream infection. After five to seven days of intravenous antimicrobial therapy, participants were randomly assigned to oral antimicrobial therapy or to continue intravenous standard therapy (108 and 105, respectively). The composite primary end point was the occurrence of any complication related to S. aureus bloodstream infection within 90 days.
The researchers found that the primary end point was met by 13 and 12 percent of participants in the oral switch and intravenous groups, with a treatment difference of 0.7 percentage points (95 percent confidence interval, â7.8 to 9.1; P = 0.013, which met noninferiority). Within the safety population, 34 and 26 percent of participants in the oral switch and intravenous groups, respectively, had at least one serious adverse event.
“This study supports an early switch to oral antimicrobial therapy in patients with low-risk S. aureus bloodstream infection provided a rigorous clinical assessment and close monitoring for complications are done,” the authors write.
Several authors disclosed ties to the pharmaceutical industry.
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