“While streptococcal bacteremia is fairly common, physicians have a surprisingly small amount of data to guide them in choosing optimal antibiotic treatments,” says Dana Clutter, MD, Infectious Diseases physician at KP South San Francisco.
Streptococcal infections that move into the bloodstream are a common cause of hospitalization and are associated with significant mortality, with approximately 16% of those infected dying from its complications. For many decades, the standard course of treatment has been 2 weeks of intravenous antibiotics, but their prolonged use is also associated with numerous side effects and complications.
“We aimed to determine if switching from intravenous to oral therapy was as effective as entirely intravenous therapy, and whether shorter regimens were as good as longer ones,” Dr. Clutter says.
Dr. Clutter’s study included more than 1,400 adult patients treated for uncomplicated streptococcal bacteremia from 2013 to 2020 in KP Northern California. She found no differences in serious outcomes (infection recurrence, hospital readmission, or mortality) between 5- to 10-day and 11- to 15-day courses of antibiotic treatment, and no significant risks associated with switching from intravenous to oral antibiotics when leaving the hospital.
“The impact of this research is that if patients can receive shorter durations of treatment, we can eliminate side effects such as drug toxicity, drug resistance, and C. diff infections, as well as central line infections and blood clots,” says Ed Kao, MD, KP South San Francisco physician-in-chief.
Published in the journal Antimicrobial Agents and Chemotherapy in August 2024, the study is the largest to date of patient outcomes by duration and route of therapy for uncomplicated streptococcal bacteremia.
“Not only is Dr. Clutter a busy infectious diseases clinician taking care of patients,” says Betty Suh-Burgmann, MD, chair of the KP Northern California Central Research Committee, “but she has also gone the extra step of trying to improve their care by advancing knowledge about a problem she sees often in practice.”