Transitional (intravenous to oral) antibiotic therapy.
Most clinicians feel the best clinical outcome occurs when patients are treated for serious infections with injections for the entire illness. Unfortunately, this type of prescribing style results in considerable indirect costs such as those involved in increased labor (nursing, pharmacy, intravenous technician time), supplies (needles, syringes, intravenous solutions, administration sets, infusion pumps) and nosocomial bacteremia. It now appears from pharmacodynamic and pharmacoeconomic information that this traditional prescribing behavior should change in the management of many infectious diseases, particularly in those clinically stable patients who can ingest or digest a medication. With the presence of numerous antibiotics with high bioavailability, many infections in such patients can now be successfully treated with an oral agent. This review provides examples of common infections (such as community- and hospital-acquired pneumonias, intra-abdominal infections, urinary tract infections, and skin, soft tissue, and bone infections) in which oral therapy can replace parenteral agents.
Quintiliani
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Anti-infective Research & Pharmacoeconomic Studies, Hartford Hospital, CT 06102, USA.
Grant
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Quintiliani
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D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics / Q000494:pharmacology; D019985:Benchmarking; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D004334:Drug Administration Schedule; D016527:Drug Costs; D011307:Drug Prescriptions; D004363:Drug Utilization; D017850:Economics, Pharmaceutical; D006801:Humans; D007275:Injections, Intravenous; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents