Related Experiment Video

Updated: Aug 7, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

HOMEFREE: Scaling-Up Evidence-Based Guidelines for IV-to-Oral Antibiotic Switch in Hospitalised Children, an

Jessica Suna1,2, Daniel Tanti3,4, Adam Bartlett3,4

  • 1University of Queensland, Brisbane, Australia.

Journal of Paediatrics and Child Health
|August 6, 2026
PubMed

Insights

Implementing IV-to-oral antibiotic switch guidelines in children significantly improves timely transitions and antibiotic cessation. This study assesses the feasibility of scaling this successful approach across diverse Australian hospitals.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Health Services Research

Background:

  • Intravenous (IV) antibiotics are common in hospitalized children, leading to complications and increased costs.
  • A pilot program using Australasian Stewardship of Antimicrobials in Paediatrics (ANZPID-ASAP) guidelines improved IV-to-oral switch rates from 64% to 82% in a tertiary pediatric hospital.
  • A larger study is needed to evaluate scaling this approach across various hospital types and sizes in New South Wales, Australia.

Purpose of the Study:

  • To test the hypothesis that an IV-to-oral antibiotic switch program, guided by endorsed guidelines and supported by audit and feedback, increases timely transitions to oral therapy or antibiotic cessation in hospitalized children.
  • To evaluate the effectiveness and implementation feasibility of this program across different pediatric and general hospitals, including metropolitan and rural settings.
  • To present the protocol for the HOMEFREE study.

Main Methods:

  • Prospective audits will assess effectiveness, focusing on timely guideline-concordant IV-to-oral switches and hospital length of stay.
  • Sites will implement context-specific interventions to support guideline adherence, informed by shared learning.
  • Implementation feasibility will be evaluated using the Consolidated Framework for Implementation Research via surveys of project committee members before and after 12 months of audit and feedback.

Main Results:

  • The study protocol is presented, outlining the methodology for evaluating the IV-to-oral antibiotic switch program.
  • Key outcomes will include the proportion of children meeting eligibility criteria for switch within 24 hours and overall hospital length of stay.
  • Implementation feasibility will be assessed through pre- and post-intervention surveys.

Conclusions:

  • This study aims to determine the effectiveness and feasibility of implementing and scaling best-practice IV-to-oral antibiotic switch guidelines for pediatric patients in diverse real-world hospital environments.
  • The findings will inform broader adoption of antimicrobial stewardship strategies to optimize antibiotic use in children.
Abstract

Related Concept Videos

IV Infusion to Oral Dosing: Conversion Methods01:28

IV Infusion to Oral Dosing: Conversion Methods

The development of extended-release formulations has facilitated the transition from intravenous to oral medication, offering a more convenient and patient-friendly approach to drug administration. This transition, however, requires careful management to ensure that therapeutic drug levels are maintained, preserving efficacy and avoiding adverse effects. Understanding pharmacokinetic principles and dosage calculations is critical during this process.Pharmacokinetics of the...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
Dosage Interval and Administration Route: Determination Methods01:19

Dosage Interval and Administration Route: Determination Methods

A medication’s effectiveness largely depends on its appropriate dosage and the route of administration. Dosage ensures that a sufficient drug concentration is maintained in the bloodstream to elicit the desired therapeutic effect without causing toxicity. The route of administration affects the drug's bioavailability, rate of absorption, and onset of action, which are crucial for achieving optimal therapeutic outcomes. Drug dosage calculations are critical to tailoring therapy to individual...
Scale-Up Processes01:14

Scale-Up Processes

The scale-up of microbial fermentation processes is essential in industrial biotechnology, allowing the transition from laboratory-scale experiments to commercial-scale production while aiming to maintain product yield and quality. This process requires meticulous adjustment of equipment design, process parameters, and contamination control strategies to accommodate increasing culture volumes.At the laboratory scale, cultures are typically maintained in 1 to 10-liter glass or autoclavable...