April 17, 2023
LAC+USC Media Relations, 323-409-6899
LAC+USC Medical Center Doctors Use Oral Antibiotics Safely and Effectively for Complex Infections, Revolutionizing Treatment Approach
Los Angeles, CA – LAC+USC Medical Centers ID physicians are revolutionizing the approach of doctors to the treatment of complex infections like endocarditis, bacteremia, and osteomyelitis. A groundbreaking JAMA article highlights the effectiveness and safety of oral therapy as an alternative to traditional IV-only therapy.
The article features the true story of an experience that Dr. Heger had with a life-threatening abscess caused by a retained screw from a previous surgery. Initially prescribed weeks of IV treatment at an outside hospital, Drs. Spellberg and Baden advised that she switch to oral antibiotics instead, avoiding the need for a PICC line. This practice, which has been widely adopted at LAC+USC Medical Center, is based on recent analyses of 21 randomized controlled trials, all of which show that oral therapy can be effectively administered for patients with bone, blood, and heart valve infections, while avoiding the harmful side effects of the long-term IV catheter. Unfortunately, as the authors write, despite these numerous clinical trials, doctors continue to unnecessarily insist on using long-term IV antibiotics. The authors wrote the article to put a human face to this challenge. Dr. Heger’s case highlights the power of oral therapy to be lifesaving and provide patients with a safer and more comfortable option. Dr. Spellberg notes that “Medicine is a very conservative profession—the practice patterns we learn during training are hard to break over the years. But when new, practice-changing studies are published, we owe it to our patients to change our care.”
The paper acknowledges that oral antibiotic therapy may not be appropriate for all patients, and reasonable selection criteria have been proposed. However, for patients who meet the criteria, oral therapy can provide an effective and safe alternative to traditional IV-only therapy. The paper also provides critical insights into the treatment of infections and the importance of being curious and humble enough to re-evaluate one’s practices. Dr. Heger expresses her gratitude to her colleagues, saying, “It is always a humbling experience to find yourself at death’s door and unable to care for yourself; but it is an amazing experience to have colleagues and friends like Drs. Spellberg and Baden to come to the rescue… Their evidence-based knowledge and courage to apply this knowledge to a friend and colleague is a tribute to the quality and thoughtful care that they put into each and every patient at this Medical Center. Thank you!”
This article will undoubtedly have a significant impact on medical practices worldwide, as doctors re-evaluate their approaches to treating complex infections.