IV to oral switch (IVOST)
Making the switch from IV to oral
The majority of patients presenting with a severe infection who require IV therapy initially can be switched to oral therapy after 24-48 hours provided that they are improving clinically and are able to tolerate an oral formulation.
Benefits of early switch
- Reduction in the likelihood of hospital acquired bacteraemia, and infected/phlebitic IV lines
- Patient is more likely to receive antibiotics at the correct time and miss fewer doses
- Potential reduction in the risk of adverse effects; errors in preparation are significantly higher with parenteral drugs, compared to oral formulations
- Reduces patient discomfort and enables improved mobility and the possibility of earlier discharge from the hospital
- Saves both medical and nursing time
- Potential reduction in treatment costs allowing finances to be better spent elsewhere
IV to oral switch therapy is NOT appropriate in critically ill patients who require IV antimicrobials or in patients unable to absorb drugs after oral administration
When a patient has an enteral tube (e.g. N/G or PEG) in place that allows medication to be administered reliably, a switch to an appropriate oral formulation of the antibiotic administered via the tube, may be considered provided that gastric motility has been established. Care must be taken when administering antibiotics via the enteral tube due to the potential for interactions with feeds e.g. ciprofloxacin, flucloxacillin. For further information on any aspect of drug administration via an enteral tube, check Guidelines For The Administration Of Medicines To Adults Via Enteral Tubes Within NHS Grampian, contact Medicines Information (Ext 52316) or your ward Clinical Pharmacist.
Published: 16/06/2022 16:22