Oral to IV Conversion

• The optimal time to consider switching a patient to oral therapy is after 2 to 4 days of intravenous therapy.T
• his period of time allows the clinician to evaluate the patient’s microbiology results and assess their response to treatment. 
• A large number of clinical trials support the early switching to oral antibiotics after this period of time with equal treatment efficacy and no adverse effects on patient outcome
• A patient must meet a number
  of criteria prior to switching:
  • Display signs of clinical improvement (Box 1)
  • Able to tolerate oral therapy (Box 2)
  • Not have a condition in which higher concentrations of antibiotic are required in the tissue/prolonged course of IV therapy is essential(Box 4)
• There are a number of conditions in which a switch to oral therapy should be considered including:
  • Pneumonia
  • Skin and soft tissue infections
  • Urinary tract infections
  • Uncomplicated Gram negative bacteraemia
  • Intra-abdominal infection without deep seated collections

References:

1. Intravenous to Oral Switch Guideline for Adults Patients –can antibiotics S.T.O.P. South Australian expert Advisory Group on Antibiotic Resistance (SAAGAR)
2. Focus on Converting from IV to PO Antibiotic Therapy.