{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T20:42:20Z","timestamp":1791751340296,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Gram\u2010negative bacteremia (GNB) is associated with significant morbidity and mortality. Transition to oral therapy has traditionally utilized fluoroquinolones or trimethoprim\u2010sulfamethoxazole rather than beta\u2010lactams due to concerns about pharmacokinetics and bioavailability despite a dearth of clinical data. The purpose of this meta\u2010analysis is to evaluate the clinical efficacy of transition to oral beta\u2010lactam therapy in uncomplicated GNB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a meta\u2010analysis of published articles in MEDLINE, Embase, and Web of Science databases from inception to September 2024. Inclusion criteria included any study with adults (age &gt;18 years of age) with uncomplicated GNB from any source. Primary outcomes included 30\u2010day all\u2010cause mortality and 30\u2010day antibiotic failure rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight retrospective cohort studies were reviewed comprising 7500 patients. Twice as many patients were in the fluoroquinolones\/trimethoprim\u2010sulfamethoxazole group compared with the beta\u2010lactams group (4998 vs. 2482). Patients in each group had similar average age (70 vs. 71), percent male (54% vs. 56%), percent urinary source (78% vs. 80%), duration of IV antibiotics (4.2 vs. 4.5), Pitt bacteremia score (1.1 vs. 1.4) and Charleston comorbid index (2 vs. 2). There was no statistically significant difference in the 30\u2010day all\u2010cause mortality rate between the fluoroquinolones\/trimethoprim\u2010sulfamethoxazole and the beta\u2010lactams group: 2.06% versus 1.89% with a weighted relative risk ratio of 1.24 (95% confidence interval [CI]: 0.86\u20131.77) or the 30\u2010day antibiotic failure rate: 2.08% vs. 3.42%, weighted relative risk ratio of 1.29 (95% CI: 0.97\u20131.71).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is no statistically significant difference in 30\u2010day mortality or antibiotic failure rates between BL and FQ\/TMP\u2010SMX as transition to oral therapy in treating uncomplicated GNB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhm.70041","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T11:24:27Z","timestamp":1743852267000},"page":"866-873","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Transition to oral beta\u2010lactam therapy in uncomplicated gram\u2010negative bacteremia: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9074-9872","authenticated-orcid":false,"given":"Michael","family":"Dore","sequence":"first","affiliation":[{"name":"Durham Veteran's Affairs Medical Center Durham North Carolina USA"},{"name":"Duke University School of Medicine Durham North Carolina USA"},{"name":"Uniformed Services University of the Health Sciences Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6071-1574","authenticated-orcid":false,"given":"Ryan","family":"Duffy","sequence":"additional","affiliation":[{"name":"Durham Veteran's Affairs Medical Center Durham North Carolina USA"},{"name":"Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Caputo","sequence":"additional","affiliation":[{"name":"Durham Veteran's Affairs Medical Center Durham North Carolina USA"},{"name":"Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily","family":"Huang","sequence":"additional","affiliation":[{"name":"Durham Veteran's Affairs Medical Center Durham North Carolina USA"},{"name":"Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Sidoti","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Cantrell","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair","family":"Glasgo","sequence":"additional","affiliation":[{"name":"Durham Veteran's Affairs Medical Center Durham North Carolina USA"},{"name":"Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christa","family":"Kerbow","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics9120922"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2021.106451"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.6226"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae007"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.20166"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.52314"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz364"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a816"},{"key":"e_1_2_10_10_1","unstructured":"European Medicines Agency: Science Medicines Health.Fluoroquinolone and quinolone antibiotics: PRAC recommends new restrictions on use following review of disabling and potentially long\u2010lasting side effects.2018. 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