[Treatment of uncomplicated Gram-negative bloodstream infections]

Gram-negative bloodstream infections represent a significant public health challenge and are associated with high mortality rates. The most frequently identified bacterium is Escherichia coli. The estimated global incidence is 48 per 100,000 person-years. The source of these bloodstream infections is predominantly urinary or gastro-intestinal. Effective management requires the timely identification of the organism and the infection source, as well as the prompt initiation of antibiotics. A 7-day course has been shown to be non-inferior to a 14-day course for uncomplicated bacteriemia, and an oral switch can be considered after 3 to 5 days of intravenous treatment. Given their significant collateral impact on the gut microbiota and the resulting selection of resistant organisms, quinolones should be avoided. Repeated blood cultures do not appear to improve clinical outcomes.