This study states that In complicated Staphylococcus aureus bacteremia (SAB), guidelines recommend prolonged intravenous (IV) antibiotic therapy for at least 4–6 weeks [1]. Few studies suggest the safety of sequential IV to oral switch in these patients [2, 3]. Also, bone and joint infections, which are common metastatic infections in SAB, can be safely managed with predominant oral treatment [4]. In these patients, early IV-oral switch is associated with shorter hospital stay and fewer complications [4]. Our institute has the policy that patients with SAB with nonendovascular metastatic infectious foci can be treated with oral antibiotics after 14 days of IV treatment. This study determined the outcome and adverse events of this strategy in comparison to prolonged IV treatment.

In this retrospective observational study, all adult patients with complicated SAB, defined as the presence of metastatic infections, admitted to our hospital from 2013 until 2020 were eligible for inclusion. Exclusion criteria were endocarditis or other endovascular infections, no 2-[18F]fluoro-2-deoxy-D-glucose–positron emission tomography/computed tomography (18F-FDG-PET/CT) and echocardiography performance, and death within 14 days. The regional ethics committee approved this study and waived the requirement to obtain informed consent (no. 2019–6025). We manually retrieved clinical characteristics of all patients from the electronic medical charts, including outcome 3 months after discontinuation of treatment.

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