{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:50Z","timestamp":1787022110132,"version":"build-2736575974"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Limited studies evaluate the outcome of intravenous antibiotics to oral transition in Gram-negative bloodstream infection (GN-BSI), particularly GN-BSI originating outside the urinary tract. This study aimed to evaluate treatment success in patients with GN-BSI treated with either intravenous therapy or intravenous to oral transition and to identify factors associated with treatment failure in those undergoing intravenous to oral transition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted at King Chulalongkorn Memorial Hospital, Thailand. Patients were included if they were \u226518 years of age, hospitalized in general medical wards with GN-BSI between August 1, 2015, to July 31, 2020, received intravenous antibiotic agents and had a functioning gastrointestinal tract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 955 patients, 545 (57.1%) were in the intravenous to oral transition group. The urinary tract was the most common source of infection (38.8%). Ciprofloxacin was the most prescribed oral antibiotic (53%). Treatment success occurred in 94.3% in the intravenous antibiotic to oral transition group. There was no significant difference in treatment success between the two groups (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.790) with a concordant result after using propensity score matching (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.223). Independent predictors of treatment failure in the intravenous to oral transition group included metastatic solid cancer (aOR = 4.355), HIV infection with CD\n                      <jats:sub>4<\/jats:sub>\n                      &lt; 200 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      (aOR = 8.452), qSOFA score \u2265 2 (aOR = 2.545), multidrug-resistant infection (aOR = 2.849), and respiratory tract infection (aOR = 8.447). Hospital length of stay in the intravenous to oral transition group was shorter than in the intravenous group (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Intravenous to oral transition may be a practical approach in GN-BSI. Patients with Gram-negative bacteremia who have HIV infection with CD\n                      <jats:sub>4<\/jats:sub>\n                      &lt; 200 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      , multidrug-resistant infections, and respiratory tract sources of infection may not be ideal candidates for this approach. Future research is needed from a randomized controlled trial.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0273369","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T13:58:34Z","timestamp":1663855114000},"page":"e0273369","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Intravenous to oral transition of antibiotics for gram-negative bloodstream infection at a University hospital in Thailand: Clinical outcomes and predictors of treatment failure"],"prefix":"10.1371","volume":"17","author":[{"given":"Titawadee","family":"Pradubkham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gompol","family":"Suwanpimolkul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan Edward","family":"Gross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6141-618X","authenticated-orcid":true,"given":"Chotirat","family":"Nakaranurack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"issue":"6","key":"pone.0273369.ref001","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/1469-0691.12195","article-title":"Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe","volume":"19","author":"M Goto","year":"2013","journal-title":"Clin Microbiol Infect"},{"issue":"3","key":"pone.0273369.ref002","doi-asserted-by":"crossref","first-page":"e013665","DOI":"10.1136\/bmjopen-2016-013665","article-title":"Swiss Centre for Antibiotic Resistance (ANRESIS). 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