Implementing criteria-based early switch/early discharge programmes: a European perspective.

Area of Science:

• Infectious Diseases
• Hospital Administration
• Antimicrobial Stewardship

Background:

• Early switch (ES) from intravenous (IV) to oral antibiotic therapy is a key component of antimicrobial stewardship.
• Highly bioavailable oral antibiotics are safe and effective for most non-critically ill patients.
• Combining ES with early discharge (ED) plans maximizes benefits.

Purpose of the Study:

• To highlight the benefits of combining early switch (ES) from IV to oral antibiotics with early discharge (ED) plans.
• To identify barriers hindering the implementation of ES and ED programs.
• To emphasize the need for developing and documenting the success of these programs.

Main Methods:

• Review of published studies on ES and ED programs.
• Analysis of benefits including patient comfort, reduced adverse events, and cost savings.
• Identification of implementation barriers such as clinician misconceptions and lack of awareness.

Main Results:

• ES and ED programs lead to decreased healthcare resource use and costs.
• Combined ES and ED improves patient comfort, reduces IV-line complications, and shortens hospital stays.
• Significant barriers to implementation include clinician misconceptions and organizational factors.

Conclusions:

• Combining early switch (ES) from IV to oral antibiotics with early discharge (ED) is a cost-effective stewardship strategy.
• Addressing barriers like clinician misconceptions and lack of awareness is crucial for maximizing program effectiveness.
• Healthcare facilities must develop and document the success of ES and ED programs as mandated by national initiatives.