281 results match your criteria: "Intravenous-to-Oral Switch Therapy"
Environmental impact of intravenous versus oral administration materials for acetaminophen and ketoprofen in a French university hospital: an eco-audit study using a life cycle analysis.
Can J Anaesth
November 2024
University of Lyon, INSA-Lyon, Villeurbanne, France.
Article Synopsis
- The study examines the environmental impact of administering acetaminophen and ketoprofen either orally or intravenously in a French hospital setting, focusing on greenhouse gas emissions and water usage.
- A life cycle assessment revealed that intravenous use resulted in significantly higher emissions (444-556 g CO2 equivalent) and water waste (9.8-12.2 L) compared to oral administration (8.36 g CO2 equivalent and 1.16 L of water).
- The conclusion emphasizes that switching to oral administration could greatly reduce annual emissions (by 2,900-3,700 tons) and conserve substantial water resources (58,000-74,000 m³), making it a more sustainable option for most patients.
Prescribing a Green Future: A Review of Antimicrobial Waste in Pediatric Hospitals and Practices to Promote Healthcare Sustainability.
J Pediatric Infect Dis Soc
November 2024
Department of Pharmacy, Children's Hospital Colorado, Denver, Colorado, USA.
Article Synopsis
- * The costs associated with this waste are not only financial but also contribute to antimicrobial resistance and environmental harm.
- * Proposed solutions include switching to oral medications earlier and optimizing pharmacy processes, but more research is needed to confirm their effectiveness; antimicrobial stewardship programs could help implement these changes.
Clinical, organizational, and pharmacoeconomic perspectives of dalbavancin vs standard of care in the infectious disease network.
Glob Reg Health Technol Assess
July 2024
Infectious Diseases Unit, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara - Italy.
Article Synopsis
- The study investigates the effectiveness and economic benefits of using dalbavancin for treating acute bacterial skin infections compared to standard treatments, highlighting the potential for early patient discharge.
- It analyzed data from patients treated with dalbavancin at a hospital in Italy over six years, demonstrating its role in reducing hospital stays and improving antibiotic adherence.
- Findings suggest that dalbavancin can save over €3,200 per patient by facilitating quicker discharges while managing complex infections effectively.
Physicians' understanding of antibiotic intravenous-to-oral switching-a qualitative study in Suzhou, China.
BMC Health Serv Res
May 2024
Department of Pharmacy, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Article Synopsis
- - The study explored physicians' understanding of intravenous-to-oral switch (IVOS) therapy for antibiotics at the Second Affiliated Hospital of Soochow University in China, highlighting its benefits in reducing drug resistance, adverse effects, and costs.
- - Results showed that 60% of physicians were unfamiliar with IVOS therapy, facing barriers such as a preference for IV treatments, patients' infusion perceptions, and limited drug options; many welcomed pharmacist assistance.
- - The study concluded that there’s a need to improve knowledge about IVOS therapy among Chinese physicians, suggesting computer reminders and clinical pharmacist support as potential strategies to enhance its adoption.
Nurses' attitudes, behaviours, and enablers of intravenous to oral switching (IVOS) of antibiotics: a mixed-methods survey of nursing staff in secondary care hospitals across the Midlands region of England.
J Hosp Infect
August 2024
Pharmacy Department, University Hospitals Birmingham NHS Trust, Birmingham, UK.
Background: Intravenous (IV) antibiotic use in secondary care in England is widespread. Timely appropriate intravenous to oral switch (IVOS) has the potential to deliver significant clinical and operational benefits. To date, antimicrobial stewardship (AMS) efforts around IVOS have not focused on the nursing staff who administer antibiotics, which represents a significant gap in AMS programmes.
View Article and Find Full Text PDFEarly versus late switch over of antiseizure medications from intravenous to the oral route in children with seizures: Single-blinded, randomized controlled trial (ELAIO trial).
Epilepsy Res
May 2024
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India. Electronic address:
Article Synopsis
- Early switch-over from intravenous to oral anti-seizure medications (ASMs) in hospitalized children may reduce hospitalization time, costs, and behavioral issues.
- The study compared short-term seizure recurrence and other factors between groups that switched medications early (within 24 hours of seizure freedom) and late (after 24-48 hours).
- Results showed no significant difference in seizure recurrence rates, but the early switch-over group had lower drug costs and fewer complications like thrombophlebitis.
Infectious Diseases: What You May Have Missed in 2023.
Ann Intern Med
May 2024
University of Pennsylvania Perelman School of Medicine and Annals of Internal Medicine, Philadelphia, Pennsylvania (M.S.).
Article Synopsis
- In 2023, research on infectious diseases beyond COVID-19 is highlighted, showcasing key developments relevant to internal medicine specialists.
- Key topics include updated guidelines for diagnosing infective endocarditis, management strategies for sepsis and bacteremia, and differences in mortality based on treatment options.
- Additional studies focus on HIV treatment, including the effectiveness of preexposure prophylaxis, pitavastatin for cardiovascular disease reduction, and dexamethasone for tuberculous meningitis in HIV patients.
Effectiveness of antibiotic therapy for early recurrence of peritonsillar cellulitis and abscesses: A retrospective cohort study.
Auris Nasus Larynx
June 2024
Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address:
Article Synopsis
- - The study aimed to assess the best duration of antibiotic therapy and evaluate the effectiveness of switching from intravenous to oral antibiotics early in patients with peritonsillar cellulitis and abscesses, as short-term recurrences are common and financially burdensome.
- - An analysis of 98,394 patients showed no significant rehospitalization difference between those on early oral therapy versus prolonged intravenous therapy, although longer antibiotic courses were linked to reduced rehospitalization risk.
- - The conclusion suggests that early oral switch therapy can be a good option for stable patients who can take oral medications, and recommends at least 10 days of antibiotic treatment for better outcomes.
Early switch from intravenous to oral antibiotic therapy in patients with cancer who have low-risk neutropenic sepsis: the EASI-SWITCH RCT.
Health Technol Assess
March 2024
Wellcome-Wolfson Institute for Experimental Medicine, Queens University Belfast, Belfast, UK.
Article Synopsis
- Neutropenic sepsis is a frequent issue for cancer patients undergoing treatment, leading to different practices regarding when to switch from intravenous (IV) to oral antibiotics.
- The study aimed to assess the clinical and cost-effectiveness of switching to oral antibiotics early for low-risk patients compared to standard IV care.
- The trial included 129 participants from 19 UK oncology centers but was closed early due to not meeting recruitment goals, preventing a definitive conclusion about the effectiveness of the early switch.
Challenges of antimicrobial stewardship among older adults.
Eur J Intern Med
June 2024
Medicine Department, Universitat Internacional de Catalunya, Spain; Clinical Research Pneumonia and Sepsis (CRIPS) Research Group-Vall d'Hebrón Institute Research (VHIR), Barcelona, Spain; Formation, Recherche, Evaluation (FOREVA), CHU Nîmes, Nîmes, France.
Article Synopsis
- * There is a lack of studies and guidelines specific to ASM in older patients, emphasizing the need for updated tactics to optimize antibiotic prescriptions for common infections in this demographic.
- * Successful ASM interventions include rapid diagnostics, using biomarkers, and switching to oral or subcutaneous therapies, which can lead to fewer side effects, reduced mortality rates, shorter hospital stays, and cost savings; a proposed ASM framework focuses on strategic vision, teamwork, patient-centered care, and raising awareness.
Early Switch From Intravenous to Oral Antibiotics for Patients With Uncomplicated Gram-Negative Bacteremia.
JAMA Netw Open
January 2024
Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark.
Article Synopsis
- Gram-negative bacteremia poses a worldwide health threat, making the timely switch from intravenous to oral antibiotics essential for improving patient care and resource management.
- This study investigates whether transitioning to oral antibiotics within 4 days after initial blood culture impacts 90-day overall mortality rates compared to continuing intravenous treatment for longer.
- Conducted in Copenhagen with 914 adults, using statistical methods to account for differing patient characteristics, the study found that early oral antibiotic treatment was associated with favorable outcomes.
Personalising intravenous to oral antibiotic switch decision making through fair interpretable machine learning.
Nat Commun
January 2024
Centre for Antimicrobial Optimisation, Imperial College London, London, UK.
Antimicrobial resistance (AMR) and healthcare associated infections pose a significant threat globally. One key prevention strategy is to follow antimicrobial stewardship practices, in particular, to maximise targeted oral therapy and reduce the use of indwelling vascular devices for intravenous (IV) administration. Appreciating when an individual patient can switch from IV to oral antibiotic treatment is often non-trivial and not standardised.
View Article and Find Full Text PDFDevelopment of machine learning algorithms for scaling-up antibiotic stewardship.
Int J Med Inform
January 2024
Department of Digital Healthcare, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address:
Article Synopsis
- Antibiotic stewardship programs (ASP) seek to minimize unnecessary antibiotic use, but their complex and labor-intensive nature makes them hard to implement widely; this study proposes machine learning models to help prioritize patients who need these interventions the most.
- Researchers collected extensive data on inpatients receiving antibiotics from a Korean hospital, using advanced machine learning techniques (like XGB and LGBM) to analyze over 130,000 patient-days and identify cases needing intervention.
- The machine learning models showed effective performance in classifying patient cases (e.g., identifying 41% more cases needing discontinuation compared to traditional methods) and provided insights into decision-making, potentially increasing the efficiency of ASPs.
Challenges of Antibiotic Formulations and Administration in the Treatment of Bloodstream Infections in Children Under Five Admitted to Kisantu Hospital, Democratic Republic of Congo.
Am J Trop Med Hyg
December 2023
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Article Synopsis
- Severe bacterial infections in children require quick and effective antibiotic treatment, but challenges were identified in a study at a Kisantu hospital on non-typhi Salmonella bloodstream infections.
- While 98.4% of children received antibiotics, there were significant issues with timing, administration, and dosing accuracy, with only 78.3% receiving antibiotics on the day of admission.
- Problems included the use of inappropriate administration practices, poor-quality oral formulations, and a lack of essential dosing instructions, highlighting an urgent need for improvements in antibiotic management for pediatric care.
Safety of early oral ambulatory treatment of adult patients with bloodstream infections discharged from the emergency department.
Antimicrob Agents Chemother
November 2023
Unit of Infectious Diseases, Microbiology and Parasitology, Virgen del Rocío University Hospital, Seville, Spain.
Article Synopsis
- This study looks at the safety of giving oral treatment to adult patients diagnosed with bacteremia after they leave the emergency department.
- It involved 206 patients with fever, comparing those with low-risk bacteremia who received oral treatment to similar non-bacteremic patients.
- Results showed that both groups had similar and low rates of 14-day mortality and unplanned medical visits, indicating that early oral treatment for low-risk bacteremia is safe.
Using antibiotics wisely.
Curr Opin Infect Dis
December 2023
Rush University Medical Center, Chicago, Illinois, USA.
Article Synopsis
- Shorter courses of antibiotic therapy (like 7 days for Enterobacterales and community-acquired pneumonia) are shown to be effective and can replace longer standard treatments.
- Transitioning from intravenous to oral antibiotics is safe and lowers the risk of complications, especially for conditions like bacteremia and endocarditis.
- Artificial intelligence is emerging as a tool to optimize antibiotic use, but its practical applications are still being explored and require further validation.
Dermatologic adverse effect of subcutaneous furosemide administration in a cat.
Open Vet J
August 2023
Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano dell'Emilia, Italy.
Article Synopsis
- Furosemide is commonly used to treat congestive heart failure (CHF) in pets, and this report documents the first known case of adverse skin reactions in a cat receiving subcutaneous furosemide!
- A 2-year-old domestic shorthair cat was treated for CHF and experienced relapses despite increasing furosemide doses, ultimately leading to the use of subcutaneous furosemide to manage lung edema!
- Two weeks after starting subcutaneous furosemide, the cat developed crusted ulcerative skin lesions at the injection sites, prompting the suspicion of a rare dermatologic side effect associated with furosemide, previously noted in dogs and humans.
Criteria to achieve safe antimicrobial intravenous-to-oral switch in hospitalised adult populations: a systematic rapid review.
BMJ Open
July 2023
Healthcare-Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Use & Sepsis Division, UK Health Security Agency, London, UK
Article Synopsis
- The rapid review aimed to summarize IVOS criteria for safely switching from intravenous to oral antibiotics in adult hospital patients, drawing findings from various studies published between 2017 and 2021.
- A total of 45 local IVOS policies were analyzed and organized into five main categories, focusing on review timing, clinical signs, infection markers, enteral routes, and exclusions; 33 specific criteria were identified for further evaluation.
- The review emphasized the importance of timely assessment, with suggestions for potential early reviews and the inclusion of clinical indicators such as heart rate and respiratory rate as part of the IVOS evaluation process.
Assessment of Antimicrobial Stewardship through objective structured clinical examination in pharmacy education.
Int J Pharm Pract
December 2023
Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
Objectives: To describe the implementation and assess whether an objective structured clinical examination (OSCE) is a viable assessment tool for testing Antimicrobial Stewardship (AMS) principles.
Methods: A three-station OSCE set in a hospital and community pharmacy was designed and mapped to the World Health Organisation's AMS intervention practical guide. This OSCE comprised 39 unique cases and was implemented across two campuses (Malaysia and Australia) at one institute.
Impact of clinical pharmacist-led interventions on switching from intravenous-to-oral antibiotics in patients with infectious diseases at a Vietnamese hospital.
Trop Med Int Health
August 2023
Department of Infectious Diseases, Thong Nhat Hospital, Ho Chi Minh City, Vietnam.
Article Synopsis
- The study aimed to assess how clinical pharmacist-led interventions impacted the transition from intravenous (IV) to oral (PO) antibiotics for hospitalized patients with infectious diseases.
- Researchers evaluated data from two periods: before the intervention (January to June 2021) and during the intervention (January to June 2022), focusing on patient characteristics and treatment outcomes.
- Results showed a significant increase in the switch rate from IV to PO antibiotics (44.4% to 67.8%) and appropriate conversions (43.8% to 67.5%), indicating that pharmacist involvement improved the transition process without affecting the length of hospital stays or treatment outcomes.
Switch from intravenous-to-oral antibiotics in neonatal probable and proven early-onset infection: a prospective population-based real-life multicentre cohort study.
Arch Dis Child Fetal Neonatal Ed
December 2023
Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Kobenhavn, Denmark.
Article Synopsis
- - The study evaluated the effectiveness of switching from intravenous to oral antibiotics (amoxicillin) for treating neonates with early-onset infection (EOI) and included data from 835 term-born neonates over two years.
- - Results showed that 90% of neonates with probable infection successfully switched to oral therapy, with no readmissions due to infection and a shorter average hospital stay compared to those on intravenous therapy.
- - Although oral therapy proved safe and beneficial for easing the treatment process, the overall use of antibiotics did not increase after implementing switch therapy.
Early switch from intravenous to oral anti-microbial therapy in infectious diseases.
Clin Microbiol Infect
September 2023
Hospital Administration, Los Angeles General Medical Center, Los Angeles, CA, USA.
Early switching from intravenous to oral antibiotic therapy in bone and joint infections associated with methicillin-susceptible Staphylococcus aureus bacteremia.
Infect Dis Now
September 2023
Department of Internal Medicine and Infectious Diseases, Reims Teaching Hospitals, Reims, France. Electronic address:
Objectives: We aimed to evaluate the clinical outcomes of patients with bone and joint infection (BJI) associated with methicillin-susceptible Staphylococcus aureus bacteremia (MSSAB) treated with early oral switch to oral antibiotics (before day 14) versus later or no switch.
Patients And Methods: We included all cases reported between January 2016 and December 2021 in the University Hospital of Reims.
Results: Among 79 patients with BJI associated with MSSAB, 50.
Pharmacoeconomic and antimicrobial stewardship analysis in waste management: Beyond switching drug administration route.
Am J Infect Control
December 2023
Núcleo de Gerenciamento de Antimicrobianos - Hospital Santa Cruz, Brasil. Electronic address:
Article Synopsis
- * Data from three years were analyzed, showing 275 switch therapies that saved the hospital over $55,000 and reduced waste by 170,631 grams.
- * Findings indicate that transitioning to oral therapy is safe for patients, cost-effective, and leads to significant reductions in hospital waste.
Early switch of intravenous to oral antibiotic therapy in clinically well neonates with a probable bacterial infection is as effective as a full course of intravenous antibiotics therapy.
Arch Dis Child Educ Pract Ed
August 2023
Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.