Oral Antibiotic Options for E. coli Bacteremia

Primary Oral Options for E. coli Bacteremia

• The Infectious Diseases Society of America recommends ciprofloxacin 500mg twice daily as the preferred oral step-down therapy for E. coli bacteremia when the organism is susceptible 1
• TMP-SMX 160/800mg twice daily is an alternative oral option if the organism is susceptible, particularly useful if the patient has a contraindication to fluoroquinolones, as suggested by the American Academy of Pediatrics 2
• For patients with risk factors for fluoroquinolone adverse effects, such as the elderly, those on corticosteroids, or those with renal disease, the American Academy of Pediatrics recommends considering alternative agents like TMP-SMX 2
• In patients with renal impairment, the Infectious Diseases Society of America suggests that dose adjustment may be required for TMP-SMX and some cephalosporins 1

Oral Antibiotic Treatment for E. coli Bacteremia

Introduction to Oral Treatment Options

• The Journal of Microbiology, Immunology and Infection recommends against using oral cephalosporins for bacteremia, as they are not effective for this type of infection 3

Antibiotic Selection

• Vancomycin is not effective against E. coli, as it only has activity against gram-positive organisms, according to the Journal of Microbiology, Immunology and Infection and Clinical Infectious Diseases 4, 5