Question

A 60-year-old with E. coli bacteremia from pyelonephritis improves rapidly. Cultures susceptible to ceftriaxone and TMP-SMX. When is oral step-down appropriate?

Accepted Answer

Once clinically stable and able to take PO with a highly bioavailable agent for total 7-14 days

Answer

Never; complete IV therapy

Answer

Only after repeat negative blood cultures at 72 hours

Answer

Only if procalcitonin normalizes

Answer

Oral therapy is inferior

Practice question

A 60-year-old with E. coli bacteremia from pyelonephritis improves rapidly. Cultures susceptible to ceftriaxone and TMP-SMX. When is oral step-down appropriate?