Gram-Negative Bloodstream Infection Oral Antibiotic Therapy Trial

Inclusion Criteria:

• Adult (≥ 18 years) at the time of screening

• Hospitalized

• Identification of at least one Gram-negative organism in a blood culture

• Capable of providing written informed consent (includes through a legally authorizedrepresentative)

• Willingness to adhere to assigned study arm

• Capable and willing to complete a follow-up QoL interview (including through alegally authorized representative)

Exclusion Criteria:

• Unable to tolerate or absorb a course of oral antibiotics

• Actively receiving vasopressors

• Gram-negative organism not susceptible to any oral antibiotics

• Gram-negative organism not susceptible to any IV antibiotics

• Polymicrobial bloodstream infection

• The following patients with polymicrobial infections remain eligible forenrollment: (1) more than one morphology or species of a gram-negative organism (except for Acinetobacter baumannii or Stenotrophomonas maltophilia), (2) asingle positive blood culture with a common commensal organism (grown inaddition to an Enterobacterales species or Pseudomonas aeruginosa

• Allergy or contraindication rendering no oral option or no IV option for therapywith the listed antibiotic agents.

• Anticipated duration of therapy greater than 14 days

• Central nervous system infection

• Absolute neutrophil count of <500 cells/mL or anticipated to reduce to <500 cells/mLduring the antibiotic treatment course.

• Receiving hospice care