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Evaluation of intravenous to oral antimicrobial switch at a hospital with a tightly regulated antimicrobial stewardship program
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  • Sharmila Khumra,
  • Andrew Mahony,
  • Phillip Bergen,
  • Rohan A. Elliott
Sharmila Khumra
Austin Health
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Andrew Mahony
Austin Health
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Phillip Bergen
Monash University
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Rohan A. Elliott
Austin Health
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Timely intravenous (IV) to oral antimicrobial switch (IV-oral-switch) is a key antimicrobial stewardship (AMS) strategy. A retrospective audit was undertaken to determine concordance with IV-oral-switch guidelines in the context of a long-standing, tightly regulated AMS program. Data from 107 general medical and surgical patients in an Australian hospital were analysed. Median duration of IV antimicrobial courses before switching to oral therapy was 3 days (interquartile range, 2.25-5.00). Timely IV-oral-switch occurred in 57% (n=61) of patients. The median delay to switching was 0 days (IQR 0 to 1.25). In most courses (92/106, 86.8%), the choice of oral alternative after switching was appropriate. In 45% (47/105) of courses, total duration of therapy (IV plus oral) exceeded the recommended duration by >1.0 day. Excessive IV antimicrobial duration was uncommon at a hospital with a tightly regulated AMS program. Total duration of therapy was identified as an AMS target for improvement.

Peer review status:Published

30 Aug 2020Submitted to British Journal of Clinical Pharmacology
31 Aug 2020Submission Checks Completed
31 Aug 2020Assigned to Editor
08 Sep 2020Reviewer(s) Assigned
26 Sep 2020Review(s) Completed, Editorial Evaluation Pending
24 Oct 2020Editorial Decision: Revise Major
10 Dec 20201st Revision Received
11 Dec 2020Submission Checks Completed
11 Dec 2020Assigned to Editor
11 Dec 2020Review(s) Completed, Editorial Evaluation Pending
28 Dec 2020Editorial Decision: Accept
23 Jan 2021Published in British Journal of Clinical Pharmacology. 10.1111/bcp.14734