Trial reportOpen forum infectious diseases2024
Oral β-Lactams, Fluoroquinolones, or Trimethoprim-Sulfamethoxazole for Definitive Treatment of Uncomplicated
Trial report in Open forum infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 12 citations in OpenAlex.
- The Use of Step-Down Oral Antibiotic Therapy for Uncomplicated Gram-Negative Bacteremia and Risk Factors for Adverse Outcomes.Open forum infectious diseases · 2026Trial
- Clinical outcomes with oral cephalosporins as definitive treatment of Enterobacterales bacteremia from a urinary source based on cefazolin minimum inhibitory concentration.Antimicrobial agents and chemotherapy · 2026Article
- Etiopathogenesis and Antibacterial Therapy Approach in Patients with Acute Obstructive Pyelonephritis-A Retrospective Study.Antibiotics (Basel, Switzerland) · 2026Article
- Effect of oral beta-lactam dosing on outcomes of bacteremic Gram-negative urinary tract infections: a real-world analysis.Microbiology spectrum · 2026Article
- Interventions to optimize duration of antibiotic therapy and encourage oral transition for uncomplicated gram-negative blood stream infections across a health system.Infection control and hospital epidemiology · 2026Article
- Gut check: antimicrobial stewardship opportunities in intra-abdominal infections.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Review
- Safety and efficacy of early oral switch in Enterobacterales bacteremia: a systematic review and meta-analysis.Journal of Yeungnam medical science · 2026Article
- Determinants of multidrug-resistant urinary tract infections: A retrospective cross-sectional study from a tertiary care hospital in southern Bangladesh.PLOS global public health · 2026Article
- Profile of antimicrobial resistance of uropathogens in urinary tract infections: An analysis of 1117 hospitalized patients in Brazil.IJID regions · 2025Article
- Very Early Transition to Oral Antibiotics in Uncomplicated Enterobacterales Bloodstream Infections: Effectiveness and Impact on Carbon Footprint Saving.Antibiotics (Basel, Switzerland) · 2025Article
- Antibiotic Treatment of Infections Caused by AmpC-Producing Enterobacterales.Pharmacy (Basel, Switzerland) · 2024Review
- Rise of the beta-lactams: a retrospective, comparative cohort of oral beta-lactam antibiotics as step-down therapy for hospitalized adults with acute pyelonephritis.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Fluoroquinolones (FQs) are effective for oral step-down therapy for gram-negative bloodstream infections but are associated with unfavorable toxic effects. Robust data are lacking for trimethoprim-sulfamethoxazole (TMP-SMX) and high-bioavailability β-lactams (HBBLs). Methods: In this multicenter observational cohort study, we simulated a 3-arm registry trial using causal inference methods to compare the effectiveness of FQs, TMP-SMX, or HBBLs for gram-negative bloodstream infections oral step-down therapy. The study included adults treated between January 2016 and December 2022 for uncomplicated Results: Of 2571 patients screened, 648 (25%) were included. Their median age (interquartile range) was 67 (45-78) years, and only 103 (16%) were male. Characteristics were well balanced between groups. Compared with FQs, TMP-SMX had similar effectiveness (adjusted hazard ratio, 0.91 [95% confidence interval, .30-2.78]), and HBBLs had a higher risk of recurrence (2.19 [.95-5.01]), although this difference was not statistically significant. Most HBBLs (70%) were not optimally dosed for bacteremia. A total antibiotic duration ≤8 days was associated with a higher recurrence rate in select patients with risk factors for failure. Conclusions: FQs and TMP-SMX had similar effectiveness in this real-world data set. HBBLs were associated with higher recurrence rates but suboptimal dosing may have contributed. Further studies are needed to define optimal BL dosing and duration to mitigate treatment failures.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.