Early conversion of intravenous to oral antibiotic therapy in uncomplicated urinary and respiratory tract infection

Abstract

Early conversion from intravenous to oral antibiotic therapy is an effective way to save costs and promote earlier hospital discharge. This study was conducted to evaluate the impact of intravenous to oral conversion of antibiotic therapy with respect to clinical outcomes. An ambispective observational study constitutes two phases—a retrospective phase where intravenous to oral conversion was performed before active involvement of the clinical pharmacist, and a prospective phase consisting of pharmacist recommendations for the early conversion of intravenous to oral route. In this study, 83 and 88 patients were included in the retrospective and prospective phases, respectively. As per the criteria for an intravenous to oral switch, 71 (86%) patients in the retrospective phase and 84 (95%) patients in the prospective phase were eligible for conversion, of whom 13 (18%) and 66 (79%) patients, respectively, were switched. The average length of hospital stay was found to be 4.4 ± 0.7 days in the retrospective phase and 6.0 ± 1.5 days in the prospective phase (p 0.05). The additional number of intravenous therapy days decreased from 112 days in the retrospective phase to 35 days in the prospective phase. This study emphasizes that the practice of conversion from intravenous to oral antibiotic therapy has a considerable impact on clinical outcomes among hospitalized inpatients. There was no observed difference in readmission and reinfection rates after early conversion to oral therapy.