Clinical Manifestations
- Source of bacteremia
- Respiratory tract infection (especially critically ill patients)
- Central line-associated bloodstream infection (especially critically ill patients)
- Urinary tract infection (most common source in elderly patients)
- Gastrointestinal or biliary tracts
- Skin and soft tissue infection
Management
- Duration of 7 days of antibiotics is likely reasonable for most uncomplicated gram-negative bacteremias, regardless of source
- Can be narrowed based on antibiotic spectrum
- Can be switched or oral antibiotics once stable
- Highly bioavailable non-beta-lactams: ciprofloxacin, levofloxacin, moxifloxacin (if not a urinary source), or co-trimoxazole
- Beta-lactams: amoxicillin, amoxicillin-clavulanic acid, cephalexin, cefadroxil, cefixime; can consider the following higher doses
- Amoxicillin 1 g p.o. three times daily
- Amoxicillin-clavulanic acid 875 mg/125 mg p.o. three times daily
- Cephalexin 1 g p.o. four times daily
- Cefadroxil 1 g p.o. twice daily
- Cefixime 400 mg p.o. twice daily (corresponds to usual dose)
