Oral cephalosporins for use in a parenteral-to-oral switch programme

The advent of the newer cephalosporins has increased the feasibility of parenteral-oral switch programmes within this group of antibacterials. The choice of oral compound is governed by consideration of comparative data on in vitro activity and pharmacokinetics, with particular reference to the antibacterial levels achievable in relevant tissues. The establishment of strict patient criteria and an intensive programme of continuous education of the junior doctors are critical elements in the success of a switch programme. We have continuously audited the implementation, practice and financial results of a parenteral-to-oral switch programme from cefotaxime to cefixime during the past 3 years. Results from this audit finally demonstrated a reversal in the upward trend of cephalosporin expenditures in 1994-95.