{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:16:45Z","timestamp":1784791005242,"version":"3.55.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,6,25]],"date-time":"2022-06-25T00:00:00Z","timestamp":1656115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antibiotic therapy for uncomplicated Enterobacterales bacteremia from a urinary source has traditionally consisted of fluoroquinolones (FQs) and sulfamethoxazole-trimethoprim (SXT). However, adverse events associated with FQs and emerging antimicrobial resistance have led to alternative agents, specifically oral \u0392-lactams (OBLs), being utilized despite concern of subtherapeutic serum concentrations related to their low relative bioavailability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare efficacy of antibiotic therapies with bioavailability differences in patients with uncomplicated bacteremia from a urinary source.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a retrospective study comparing clinical efficacy in hospitalized adult patients receiving OBL or FQ\/SXT. Patients were required to receive at least 48 hours of appropriate intravenous antibiotic therapy and at least one dose of oral therapy. The primary outcome was all-cause hospital readmission within 30 days of discharge. Secondary outcomes included readmission with recurrent infectious etiology and readmission due to\n                      <jats:italic toggle=\"yes\">Clostridioides difficile<\/jats:italic>\n                      infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 210 eligible patients, 91 received FQ\/SXT and 119 received OBL. There was no difference between the groups in all-cause hospital readmission (FQ\/SXT: 16.5%; OBL: 14.3%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.660 [95% confidence interval, CI = \u22120.076, 0.120]) or readmission with recurrent bacteremia (FQ\/SXT: 0%; OBL: 3.4%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.135). There was a significant difference in repeat hospital admission with recurrent urinary tract infection (UTI) (FQ\/SXT: 0%, OBL: 5.0%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>OBLs appear to be non-inferior to FQ\/SXT in the rate of all-cause hospital readmission within 30 days. However, OBLs may be associated with increased readmissions with recurrent UTI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280221106789","type":"journal-article","created":{"date-parts":[[2022,6,25]],"date-time":"2022-06-25T05:36:32Z","timestamp":1656135392000},"page":"251-258","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Use of Fluoroquinolones or Sulfamethoxazole-Trimethoprim Compared to \u0392-Lactams for Oral Step-Down Therapy in Hospitalized Patients With Uncomplicated Enterobacterales Bacteremia"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-3222","authenticated-orcid":false,"given":"Tyler","family":"Mack","sequence":"first","affiliation":[{"name":"Indiana University Health Hospitals and Clinics, Indianapolis, IN, USA"},{"name":"Department of Pharmacy, Cleveland Clinic Lutheran Hospital, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon J.","family":"Hiles","sequence":"additional","affiliation":[{"name":"Indiana University Health Hospitals and Clinics, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Wrin","sequence":"additional","affiliation":[{"name":"Indiana University Health Hospitals and Clinics, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armisha","family":"Desai","sequence":"additional","affiliation":[{"name":"Indiana University Health Hospitals and Clinics, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,6,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12085."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12195."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-8579(09)70567-9."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001393."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir063."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy1054."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix767."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.09.001."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2099."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix733."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/106002809603000605."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2017.12.007."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2019.1594774."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz364."},{"key":"e_1_3_2_16_2","unstructured":"FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. FDA Drug Safety Communication. Updated December 21 2018. Accessed January 28 2022. https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-warns-about-increased-risk-ruptures-or-tears-aorta-blood-vessel-fluoroquinolone-antibiotics."},{"key":"e_1_3_2_17_2","unstructured":"FDA reinforces safety information about serious low blood sugar levels mental health side effects with fluoroquinolone antibiotics; requires label changes. FDA Drug Safety and Availability. Updated July 10 2018. Accessed January 28 2022. https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-reinforces-safety-information-about-serious-low-blood-sugar-levels-and-mental-health-side."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.20166."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01515-20."},{"key":"e_1_3_2_20_2","unstructured":"Cephalexin (cephalexin) [package insert]. 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