134 Chapter 6 The following questions refer to oral step-down therapy in MSSA/MRSA bacteremia. Do you consider oral step-down antibiotic therapy in patients with uncomplicated Staphylococcus aureus bacteremia? o Yes o No Do you consider oral step-down antibiotic therapy in patients with Staphylococcus aureus bacteremia and the following foci of infection? Mark all that apply. □ Brain abscess □ Central line infection □ Epidural abscess □ Native joint septic arthritis □ Native valve endocarditis □ Osteomyelitis □ Prosthetic joint septic arthritis □ Prosthetic valve endocarditis □ Skin- and soft tissue infection without abscess □ Urinary tract infection □ Vertebral osteomyelitis □ None of the above In your opinion, which of the following criteria must a patient with Staphylococcus aureus bacteremia who is able to take oral medication fulfill to be eligible for oral step-down antibiotic therapy? Mark all that apply. □ Absence of central nervous system infection □ Absence of endovascular infection focus other than endocarditis □ Blood culture negativity 48-72 hours after initiation of adequate antibiotic treatment □ Blood culture negativity for at least 72 hours □ Defervescence within 72 hours after initiation of adequate antibiotic treatment □ Afebrile for at least the past 72 hours □ Hospital acquired bacteremia □ Initiation of adequate antibiotic treatment within 48 hours of blood culture collection □ PET-CT without signs of endocarditis and metastatic infections □ No evidence of metastatic foci (on clinical of radiologic examination, but radiological imaging is not required if not clinically indicated) □ Primary infection focus was line related or skin/soft tissue related □ Source control is achieved □ Transesophageal echocardiography (TEE) without signs of endocarditis □ Transthoracic echocardiography (TTE) without signs of endocarditis □ None of the above
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