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

• Main Authors: Juliano Gasparetto, Felipe Francisco Tuon, Dayana dos Santos Oliveira, Tiago Zequinao, Gabriel Rammert Pipolo, Gabriel Velloso Ribeiro, Paola Delai Benincá, June Alisson Westarb Cruz, Thyago Proenca Moraes
• Format: Article
• Language: English
• Published: BMC 2019-07-01
• Series: BMC Infectious Diseases
• Subjects: Antibiotic; Oral switch; Stewardship; Intensive care unit; Critically ill patients
• Online Access: http://link.springer.com/article/10.1186/s12879-019-4280-0
• ISSN: 1471-2334

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.