Oral step-down with β-lactams for uncomplicated Enterobacterales bacteraemia

Abstract

The preferred definitive treatments for invasive Enterobacterales infections, parenteral antibiotics, oral fluoroquinolones, and oral trimethoprim-sulfamethoxazole, are increasingly limited leading to interest in additional options [1–3]. Oral beta-lactams are a conceptionally attractive option because of their high tolerability and activity against Enterobacterales that do not meaningfully express ampC beta-lactamases, but views on their role are mixed due to concerns for subtherapeutic serum concentrations [1].