What Stops Doctors Switching from Intravenous to Oral Antibiotics?

Area of Science:

• Medical Sciences
• Clinical Pharmacy
• Infectious Diseases

Background:

• Intravenous to oral (IV-to-PO) switch therapy is a key strategy in antimicrobial stewardship.
• Optimizing IV-to-PO switch adherence can reduce healthcare costs and antimicrobial resistance.
• Understanding physician perspectives is crucial for effective guideline implementation.

Purpose of the Study:

• To investigate physician perceptions of motivators and barriers to IV-to-PO switch antibiotic guideline compliance.
• To identify potential interventions to enhance adherence to IV-to-PO switch protocols in an Irish hospital setting.

Main Methods:

• A cross-sectional survey was administered to physicians across various specialties and grades.
• Data were collected during hospital-wide educational sessions in November 2018.
• Statistical analysis was performed using SPSS software.

Main Results:

• Physicians reported awareness of local IV-to-PO switch criteria.
• Key barriers included a need for prompts, such as Kardex alert stickers and reminders from nursing and pharmacy staff.
• Suggested interventions included enhanced education for junior doctors, electronic prescribing, and improved access to laboratory results.

Conclusions:

• Physician feedback highlights the need for system-level interventions to support IV-to-PO antibiotic switching.
• Implementing targeted quality improvement initiatives based on these findings can increase guideline compliance.
• Addressing identified barriers can optimize antimicrobial stewardship and patient care pathways.