Fluoroquinolones, TMP-SMX Effective Stepdown Therapy For UTI-Related Gram-Negative BSIs, Study Finds

Infectious Disease Advisor (5/31, Kuhns) reported, “In patients with gram-negative bloodstream infections (GN-BSIs) from a complicated urinary tract infection (UTI) source, oral stepdown therapy with fluoroquinolones or trimethoprim-sulfamethoxazole (TMP-SMX) is as effective as intravenous (IV) β-lactams, according to study results published in Open Forum Infectious Diseases.” In the study, in “adjusted analysis, recurrence risk did not significantly [differ] between patients who received a full course of IV β-lactams and those who switched to either fluoroquinolones (adjusted hazard ratio [aHR], 1.09; 95% CI, 0.49-2.43) or TMP-SMX (aHR, 1.44; 95% CI, 0.54-3.87). However, a switch to high-bioavailability oral β-lactams was significantly associated with increased risk for recurrence (aHR, 3.33; 95% CI, 1.76-8.33; P <.001).”