Intravenous-to-oral antibiotic switch therapy: a cross-sectional study in critical care units

BMC Infect Dis. 2019 Jul 22;19(1):650. doi: 10.1186/s12879-019-4280-0.

Abstract

Background: This study aimed to evaluate the oral switch (OS) stewardship intervention in the intensive care unit (ICU).

Methods: This was a retrospective study with a convenience sample in two Brazilian ICUs from different hospitals in patients with sepsis receiving antibiotic therapy. The stewardship intervention included OS in patients diagnosed with sepsis when clinical stability was achieved. The primary outcome was overall mortality. Other variables evaluated were as follows: cost of antimicrobial treatment, daily costs of intensive care, acute kidney injury, and length of stay.

Results: There was no difference in mortality between the OS and non-OS groups (p = 0.06). Length of stay in the ICU (p = 0.029) was shorter and acute kidney injury incidence (p = 0.032) and costs of antimicrobial therapy (p < 0.001) were lower in the OS group.

Conclusion: OS stewardship programs in the ICU may be considered a safe strategy. Switch therapy reduced the cost and shortened the length of stay in ICUs.

Keywords: Antibiotic; Critically ill patients; Intensive care unit; Oral switch; Stewardship.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Administration, Intravenous
  • Administration, Oral
  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy*
  • Bacteremia / economics
  • Bacteremia / mortality*
  • Brazil
  • Costs and Cost Analysis
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents