title: Stimulation of the i.v. to oral switch of bioavailable drugs by phone calls in a Belgian tertiary care hospital.
abstract: BACKGROUND
  Early switch from intravenous to oral administration of drugs with an almost complete oral bioavailability, can have important benefits. Drugs with almost complete bioavailability, like clindamycin (Dalacin), levofloxacin (Tavanic) and paracetamol (Perfusalgan/Dafalgan), are very suitable for an early intravenous to oral switch in patients whose gastrointestinal absorption is intact. The aim of this study was to investigate the impact of direct phone contact between pharmacist and clinician on the intravenous to oral switch and to evaluate the reasons, mentioned by clinicians, that prevented an early switch.
  
  
  METHODS
  The project was initiated in a Belgian 1900-bed tertiary care hospital with a poster, communicated through the hospital's intranet and spread to every hospital ward. During one month, all prescriptions for intravenous clindamycin, levofloxacin and paracetamol were evaluated. The treating clinician was contacted by phone to evaluate if an intravenous to oral switch was possible.
  
  
  RESULTS
  Clinicians were contacted concerning 377 patients. For 58.7% of patients, the switch from intravenous to oral administration was made. In case of refusal, several reasons were mentioned by the clinician, some more appropriate than others.
  
  
  CONCLUSIONS
  Despite several appropriate reasons preventing an early intravenous to oral switch, there are still some aberrant opinions circulating in the hospital environment. Active interventions of pharmacists to stimulate intravenous to oral switch, using phone contact with the treating clinicians, can possibly be an adequate technique to stimulate intravenous to oral switch, but this needs to be further optimized.
authors.affiliation: Research Center for Clinical Pharmacy, University Hospitals Leuven, Leuven, Belgium. kim.vanstraelen@uzleuven.be
authors.forename: K
authors.initials: K
authors.lastname: Vanstraelen
authors.forename: J
authors.initials: J
authors.lastname: Verhaegen
authors.forename: W E
authors.initials: WE
authors.lastname: Peetermans
authors.forename: L
authors.initials: L
authors.lastname: Willems
authors.forename: I
authors.initials: I
authors.lastname: Spriet
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D061605:Administration, Intravenous; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001682:Biological Availability; D002981:Clindamycin / Q000008:administration & dosage*; D006801:Humans; D007297:Inpatients; D064704:Levofloxacin / Q000008:administration & dosage*; D010595:Pharmacists; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013689:Telephone; D063128:Tertiary Health Care
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D002981:Clindamycin; D064704:Levofloxacin