Reasons for antibiotics changes:
The reasons for changing antibiotic course are outlined in table 2. Adverse effects directly caused by intravenous antibiotic use represented over two-thirds (68%) of the documented reasons mandating a change in medication The most common reasons were due to drug intolerance/allergy (19%), clinical deterioration/rising inflammatory markers (19%), microbiology advice and drug resistances (14%) and deranged liver function tests (12%). Further detail on microbiology advice is outlined in figure 3.
When accounting for multiple reasons for one change i.e., deranged liver function tests and thrombocytopenia, adverse effects from treatment represents 63% of all reasons for changing antibiotic therapy. There was a total of 10 inpatient admissions that were directly related to adverse effects of treatment.
Other non-injurious causes for antibiotic change were drug shortages, non-compliance, administrative error, and changes for outpatient antibiotic therapy (OPAT) suitability (18% total).