Oral or intravenous antibiotics?

Area of Science:

• Infectious Diseases
• Pharmacology
• Hospital Medicine

Background:

• Intravenous (IV) antibiotics are frequently overused in hospital settings.
• Oral antibiotic therapy offers advantages, including fewer adverse effects and lower costs compared to IV administration.
• Many infections treatable with IV antibiotics can be effectively managed with oral agents.

Purpose of the Study:

• To evaluate the appropriate use of oral antibiotics as an alternative to intravenous therapy.
• To highlight infections suitable for a switch from IV to oral antibiotics.
• To discuss guidelines for timing the switch to oral therapy without compromising efficacy.

Main Methods:

• Review of current clinical guidelines and evidence regarding antibiotic administration routes.
• Identification of specific infections where a switch from IV to oral antibiotics is feasible.
• Analysis of factors influencing the decision to transition from IV to oral therapy.

Main Results:

• Oral antibiotics can successfully manage numerous infections, including pneumonia, complicated urinary tract infections, intra-abdominal infections, Gram-negative bacteremia, acute exacerbations of chronic lung disease, and skin/soft tissue infections.
• A short course of IV antibiotics followed by oral therapy is effective for many conditions.
• Research is exploring earlier oral switch options for bone and joint infections and infective endocarditis.

Conclusions:

• Optimizing antibiotic use by favoring oral over intravenous administration when appropriate can improve patient outcomes and reduce healthcare costs.
• Adherence to established guidelines facilitates safe and effective transitions from IV to oral antibiotic therapy.
• Further research into earlier oral switch protocols for complex infections is warranted.