{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T09:03:49Z","timestamp":1767690229094,"version":"3.48.0"},"reference-count":14,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Treatment of bacteremia has traditionally consisted of a 7\u201314-day course of intravenous (IV) antibiotics. Transitioning from IV to oral (PO) antibiotics in uncomplicated cases of Gram-negative and Gram-positive bacteremia is non-inferior to a complete course of IV antibiotics. High-dose oral amoxicillin has been used in practice for treating bacteremia but has limited safety and efficacy data. We conducted a retrospective chart review between June 2022 and June 2024 to characterize the use of high-dose amoxicillin and evaluate its efficacy and safety. A convenient sample size of 100 patients was used. Patients admitted to hospital who received at least one dose of high-dose amoxicillin (1 g PO TID) for the treatment of bacteremia were included. Patients undergoing hemodialysis and patients receiving amoxicillin for other infections were excluded. The average patient was a 60-year-old male (66% male) with a Gram-positive respiratory or skin source bacteremia. The median time to transition to oral amoxicillin was 5 days. The median duration of total treatment was 14 days. Respiratory sources were treated for a shorter duration, whereas skin sources were treated for longer. Readmission to hospital occurred in 28% of cases. The majority of readmissions were unrelated to the original infection, and 92% of patients were cured. There were no observed adverse events, bacteremia relapses, or deaths. In this observational study, transitioning to high-dose oral amoxicillin was primarily used for treatment of uncomplicated respiratory and skin infections with secondary bacteremia. A high rate of clinical success was observed with high-dose PO amoxicillin, with no adverse events reported.<\/jats:p>","DOI":"10.3390\/pathogens15010054","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T08:42:58Z","timestamp":1767688978000},"page":"54","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterizing the Use of High-Dose Amoxicillin for the Treatment of Bacteremia"],"prefix":"10.3390","volume":"15","author":[{"given":"Julia","family":"Lloyd","sequence":"first","affiliation":[{"name":"Pharmacy Department, St. Paul\u2019s Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Pharmacy Department, BC Children\u2019s Hospital, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Lau","sequence":"additional","affiliation":[{"name":"Pharmacy Department, St. Paul\u2019s Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy","family":"San","sequence":"additional","affiliation":[{"name":"Pharmacy Department, St. Paul\u2019s Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1031-3065","authenticated-orcid":false,"given":"Colin","family":"Lee","sequence":"additional","affiliation":[{"name":"Pharmacy Department, St. Paul\u2019s Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada"},{"name":"Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"ref_1","first-page":"107","article-title":"Oral antibiotic step-down therapy for nonstaphylococcal gram-positive bloodstream infections","volume":"4","author":"Gandhi","year":"2023","journal-title":"Diagn. 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Prescr."},{"key":"ref_5","first-page":"651","article-title":"Update on the adverse effects of antimicrobial therapies in community practice","volume":"66","author":"Mohsen","year":"2020","journal-title":"Can. Fam. Physician"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1517\/14740338.2012.643866","article-title":"Adverse reactions to \u03b2-lactam antimicrobials","volume":"11","author":"Rubinstein","year":"2012","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1177\/10600280221106789","article-title":"Use of fluoroquinolones or sulfamethoxazole-trimethoprim compared to \u0392-lactams for oral step-down therapy in hospitalized patients with uncomplicated enterobacterales bacteremia","volume":"57","author":"Mack","year":"2022","journal-title":"Ann. 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Chemother."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"ofac706","DOI":"10.1093\/ofid\/ofac706","article-title":"Can the Future of ID Escape the Intertial Dogma of Its Past? The Exemplars of Shorter Is better and Oral Is th New IV","volume":"10","author":"Davar","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"The BALANCE Investigators, for the Canadian Critical Care Trials Group, the Association of Medical Microbiology and Infectious Disease Canada Clinical Research Network, the Australian and New Zealand Intensive Care Society Clinical Trials Group, and the Australasian Society for Infectious Diseases Clinical Research Network (2025). Antibiotic treatment for 7 versus 14 days in patients with bloodstream infections. N. Engl. J. Med., 392, 1065\u20131078.","DOI":"10.1056\/NEJMoa2404991"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/1\/54\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T08:58:40Z","timestamp":1767689920000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/1\/54"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["pathogens15010054"],"URL":"https:\/\/doi.org\/10.3390\/pathogens15010054","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]}}}