The perceived superiority of intravenous (IV) over oral antibiotics drives many clinical interventions in hospitalized children. For a critically ill patient, few would question the need for IV antibiotics to ensure adequate serum levels and immediate activity. However, prolonged IV antibiotic courses are often recommended even in the face of complete resolution of symptoms. Historically, these recommendations have transcended myriad infections, including bacterial meningitis, bacteremia, urinary tract infection (UTI), osteomyelitis, and endocarditis.1,2  Although multiple studies3–5  demonstrating noninferiority of shorter IV (or even all oral) courses have helped to move the needle for some conditions,6,7  prolonged IV courses are still common. Why?

There are several potential factors that drive continuation of IV antibiotic courses beyond clinical recovery in children. Some experts voice concerns over absorption of oral antibiotics, especially in young infants. However, we are unaware of any investigations supporting this concern,...

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