Trial reportOpen forum infectious diseases2024
Real-World Effectiveness of Intravenous and Oral Antibiotic Stepdown Strategies for Gram-Negative Complicated Urinary Tract Infection With Bacteremia.
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. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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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
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Oral Stepdown Therapy for Gram-Negative Bloodstream Infections: A Systematic Review and Meta-Analysis.European journal of clinical investigation · 2026Pooled it
- A Systematic Review and Network Meta-analysis of Empirical Antibiotics for Complicated Urinary Tract Infections.Open forum infectious diseases · 2026Trial
- Review
- Bacteremia complicating urinary tract infections in hospitalized patients in a tertiary care hospital in Palestine, retrospective study.BMC infectious diseases · 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
- Safety and efficacy of early oral switch in Enterobacterales bacteremia: a systematic review and meta-analysis.Journal of Yeungnam medical science · 2026Article
- Efficacy of a transition to oral antimicrobial therapy for gram-negative bacilli bloodstream infection: systematic review and meta-analysis.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Article
- Oral quinolones versus intravenous β-lactam for the treatment of acute focal bacterial nephritis: a retrospective cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Robust data are lacking regarding the optimal route, duration, and antibiotic choice for gram-negative bloodstream infection from a complicated urinary tract infection source (GN-BSI/cUTI). Methods: In this multicenter observational cohort study, we simulated a 4-arm registry trial using a causal inference method to compare effectiveness of the following regimens for GN-BSI/cUTI: complete course of an intravenous β-lactam (IVBL) or oral stepdown therapy within 7 days using fluoroquinolones (FQs), trimethoprim-sulfamethoxazole (TMP-SMX), or high-bioavailability β-lactams (HBBLs). Adults treated between January 2016 and December 2022 for Results: Of 2571 patients screened, 759 (30%) were included. Characteristics were similar between groups. Compared with IVBLs, we did not observe a difference in effectiveness for FQs (adjusted hazard ratio, 1.09 [95% confidence interval, .49-2.43]) or TMP-SMX (1.44 [.54-3.87]), and the effectiveness of TMP-SMX/FQ appeared to be optimal at durations of >10 days. HBBLs were associated with nearly 4-fold higher risk of recurrence (adjusted hazard ratio, 3.83 [95% confidence interval, 1.76-8.33]), which was not mitigated by longer treatment durations. Most HBBLs (67%) were not optimally dosed for bacteremia. Results were robust to multiple sensitivity analyses. Conclusions: These real-world data suggest that oral stepdown therapy with FQs or TMP-SMX have similar effectiveness as IVBLs. HBBLs were associated with higher recurrence rates, but dosing was suboptimal. Further data are needed to define optimal dosing and duration to mitigate treatment failures.
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