Oral β-Lactam Antibiotics vs Fluoroquinolones or Trimethoprim-Sulfamethoxazole for Definitive Treatment of Enterobacterales Bacteremia From a Urine Source

Key Points Question Are mortality and recurrent bacteremia different for patients who receive oral β-lactam antibiotics vs fluoroquinolones or trimethoprim-sulfamethoxazole for definitive treatment of Enterobacterales bacteremia from a urinary source? Findings In this cohort study of 4089 patients, the relative risk of recurrent bacteremia at 30 days was not significantly higher with oral β-lactam antibiotics than with fluoroquinolones or trimethoprim-sulfamethoxazole, and the absolute risk difference was small. Meaning This study suggests that oral β-lactam antibiotics may be a reasonable definitive treatment when alternatives are limited by resistance or adverse effects.