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Early Transition From Parenteral to Oral Antibiotics for Neonates With Bacteremic Urinary Tract Infections

Tara L Greenhow1,2, Kritika Amanjee3, Okezi Obrutu4

  • 1Division of Infectious Diseases, Department of Pediatrics, Kaiser Permanente Northern California, San Francisco, CA, United States.

Journal of the Pediatric Infectious Diseases Society
|March 28, 2026
PubMed

Insights

Transitioning neonates with bacteremic urinary tract infections (UTIs) to oral antibiotics after initial parenteral therapy is effective. This approach showed no cases of bacteremia or meningitis within 30 days post-treatment.

Area of Science:

  • Pediatric Infectious Diseases
  • Neonatal Care
  • Pharmacology

Background:

  • Bacteremic urinary tract infections (UTIs) are a significant concern in neonates.
  • Parenteral antibiotics are the standard initial treatment for neonatal UTIs.
  • Evaluating step-down therapy to oral antibiotics can optimize treatment duration and resource utilization.

Purpose of the Study:

  • To assess the efficacy and safety of transitioning neonates with bacteremic UTIs from parenteral to oral antibiotic therapy.
  • To determine the rate of relapse and occurrence of serious complications after oral step-down therapy.

Main Methods:

  • Retrospective cohort study design.
  • Inclusion of 49 neonates diagnosed with bacteremic UTIs.
  • Analysis of treatment outcomes, including relapse rates and post-treatment complications within 30 days.

Main Results:

  • Forty-one out of 49 neonates successfully transitioned to oral step-down antibiotic therapy.
  • Only two cases of relapsed UTIs were observed in the study group.
  • No instances of recurrent bacteremia or meningitis were reported within 30 days post-treatment.

Conclusions:

  • Transitioning neonates with bacteremic UTIs to oral antibiotics following parenteral treatment is a safe and effective strategy.
  • Oral step-down therapy appears to be well-tolerated and associated with low rates of relapse and severe complications.
  • This approach may allow for shorter hospital stays and reduced healthcare costs.

Keywords:
bacteremianeonateoral antibioticsurinary tract infections

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