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Related Experiment Videos

Implementation of sequential therapy programs--a microbiologist's view

M H Wilcox1

  • 1Department of Microbiology, University of Leeds and The General Infirmary, UK.

The Journal of Infection
|November 20, 1998
PubMed
Summary
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Sequential antimicrobial therapy, switching from IV to oral antibiotics, offers benefits like cost savings and reduced infections. The Delphi technique aids in establishing best practices when guidelines are absent.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Hospital Administration

Background:

  • Sequential antimicrobial therapy (SAT) is a strategy to optimize antibiotic use, but optimal transition from intravenous to oral agents remains unclear.
  • Lack of clear guidelines for switching from intravenous cephalosporins to oral antibiotics can lead to suboptimal treatment.
  • Potential benefits of SAT include cost reduction, decreased length of stay, and reduced healthcare-associated infections.

Purpose of the Study:

  • To explore the challenges and benefits of sequential antimicrobial therapy.
  • To recommend a method for establishing consensus on optimal oral antibiotic choices following intravenous therapy.
  • To highlight the broader implications of SAT for antimicrobial stewardship and infection control.

Main Methods:

Related Experiment Videos

  • The Delphi technique was employed to achieve consensus among experts.
  • Review of case histories was used to determine acceptable practices for sequential therapy.
  • Analysis of potential economic and clinical benefits was conducted.

Main Results:

  • The Delphi technique provides a structured approach to define best practices in SAT, especially where evidence is limited.
  • Savings in drug acquisition costs and reduced hospital length of stay are achievable benefits.
  • SAT can decrease intravascular catheter infections and reduce selective pressure for resistant organisms like Clostridium difficile.

Conclusions:

  • Sequential antimicrobial therapy, when implemented correctly, offers significant advantages beyond initial cost savings.
  • The Delphi technique is a valuable tool for developing evidence-based guidelines for SAT in the absence of robust clinical trial data.
  • Implementing SAT can contribute to antimicrobial stewardship and combat the rise of hospital-acquired infections and antimicrobial resistance.