Wednesday, December 28, 2016

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. 

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