Efficacy and validity of oral switch therapy from intravenous antibiotics in the treatment of urosepsis: A propensity matching score analysis at a single center

Abstract

Introduction

Urosepsis is still a critical condition originating from a urinary tract infection. Although physicians often try to switch oral antibiotics from IV, there was no evidence to support switching to oral in the treatment of urosepsis.

Patients and methods

We retrospectively reviewed all patents with urosepsis to evaluate whether switching antibiotic therapy from IV to oral is as effective as IV antibiotic therapy during 2020–2022. Also, poor prognostic factor for 30- and in-hospital death were analyzed. Based on the antibiotic treatment, patients were divided into a switch and IV groups. Propensity-score matching (PSM) was used to balance the potential confounders, and 63 patients were selected in each group.

Results

A total of 208 patients were enrolled in the study. Sixty-seven patients were treated by switch therapy (switch group), while 101 patients were treated by IV therapy (IV group). After PSM, 63 patients were selected from each group, and the baseline characteristics were well-balanced. There were no differences in 7-, 30-day mortality, duration of hospital stay or antibiotic treatments between them. We analyzed poor prognostic factor for 30-and in-hospital death among them. The CCI score (≥3) was independent poor prognostic factor for 30-day death, and higher CCI score and higher SOFA score (≥4) were independent poor prognostic factor for in-hospital death.

Conclusion

Switching from IV to oral antibiotics is safe and effective in the treatment of urosepsis, contributing to shortening the duration of admission.