Switch Therapy: What Should Be Considered in Patients Using Antimicrobials?

Warburton J, Hodson K, James D. Antibiotic intravenous-to-oral switch guidelines: barriers to adherence and possible solutions. Int J Pharm Pract. 2014; https://doi.org/10.1111/ijpp.12086.

Broom J, Broom A, Adama K, et al. What prevents the intravenous to oral antibiotic switch? A qualitative study of hospital doctors’ accounts of what influences their clinical practice. J Antimicrob Chemother. 2016; https://doi.org/10.1093/jac/dkw129.

Cyriac JM, James E. Switch over from intravenous to oral therapy: a concise overview. J Pharmacol Pharmacother. 2014; https://doi.org/10.4103/0976-500X.1300.

• Wald-Dickler N, Holtom PD, Phillips MC, et al. Oral is the new IV. Challenging decades of blood and bone infection dogma: a systematic review. Am J Med. 2022; https://doi.org/10.1016/j.amjmed.2021.10.007. A systematic review of published, prospective, controlled trials comparing IV-only to oral stepdown regimens in the treatment of osteomyelitis, bacteremia, and endocarditis revealed that the 21 studies showed no difference in clinical efficacy or superiority of oral versus IV-only antimicrobial therapy.

Gasparetto J, Tuon FF, Dos Oliveira DS, et al. Intravenous-to-oral antibiotic switch therapy: a cross-sectional study in critical care units. BMC Infect Dis. 2019; https://doi.org/10.1186/s12879-019-4280-0.

Mouwen AMA, Dijkstra JÁ, Jong E, et al. Early switching of antibiotic therapy from intravenous to oral using a combination of education, pocket-sized cards and switch advice: a practical intervention resulting in reduce d length of hospital stay. Int J Antimicrob Agents. 2020; https://doi.org/10.1016/j.ijantimicag.2019.07.020.

Ababneh MA, Nasser SA, Rababa'h AM. A systematic review of Antimicrobial Stewardship Program implementation in Middle Eastern countries. Int J Infect Dis. 2021; https://doi.org/10.1016/j.ijid.2021.03.035.

Shrayteh ZM, Rahal MK, Malaeb DN. Practice of switch from intravenous to oral antibiotics. Springer Plus. 2014; https://doi.org/10.1186/2193-1801-3-717.

Corny J, Perreau S, Thivilliers AP, et al. Strategies for reduction in the duration of intravenous drug use: interest of drug tracers as quality indicators to improve intravenous to oral switch. J Eval Clin Pract. 2017; https://doi.org/10.1111/jep.12728.

Jones M, Huttner B, Madaras-Kelly K, et al. Parenteral to oral conversion of fluoroquinolones: low-hanging fruit for antimicrobial stewardship programs? Infect Control Hosp Epidemiol. 2012; https://doi.org/10.1086/664767.

Mertz D, Koller M, Haller P, et al. Outcomes of early switching from intravenous to oral antibiotics on medical wards. J Antimicrob Chemother. 2009; https://doi.org/10.1093/jac/dkp131.

• Kouijzer IJE, van Leerdam EJ, Gompelman M, et al. Intravenous to Oral Switch in complicated Staphylococcus aureus bacteremia without endovascular infection: a retrospective single-center cohort study. Clin Infect Dis. 2021; https://doi.org/10.1093/cid/ciab156. In a retrospective cohort study, patients with disseminated Staphylococcus aureus bacteremia were selected. The researchers observed that switching from IV to oral treatment after 14 days of IV therapy was not associated with relapses in a specific group of patients with complicated Staphylococcus aureus bacteremia.

• Iversen K, Ihlemann N, Gill SU, et al. Partial oral versus intravenous antibiotic treatment of endocarditis. N Engl J Med. 2019; https://doi.org/10.1056/NEJMoa1808312. In a randomized, multicenter trial, patients with endocarditis on the left side of the heart caused by Streptococcus, Enterococcus faecalis, Staphylococcus aureus, or coagulase-negative staphylococci, and who were receiving intravenous antibiotics, were compared in terms of either continuing intravenous treatment or switching to oral antibiotic treatment. The study observed that changing to oral antibiotic treatment was noninferior to continuing intravenous antibiotic treatment.

Itoh N, Hadano Y, Saito S, et al. Intravenous to oral switch therapy in cancer patients with catheter-related bloodstream infection due to methicillin-sensitive Staphylococcus aureus: a single-center retrospective observational study. PLoS One. 2018; https://doi.org/10.1371/journal.pone.0207413.

Kaasch AJ, Fätkenheuer G, Prinz-Langenohl R, et al. Early oral switch therapy in low-risk Staphylococcus aureus bloodstream infection (SABATO): study protocol for a randomized controlled trial. Trials. 2015; https://doi.org/10.1186/s13063-015-0973-x.

Schechter MC, Sax PE, Cortés-Penfield N. What is the best oral therapy for Staph aureus osteomyelitis? NEJM Evid. 2022; https://doi.org/10.1056/EVIDtt2200119.

Akhloufi H, Hulscher M, van der Hoeven CP, et al. A clinical decision support system algorithm for intravenous to oral antibiotic switch therapy: validity, clinical relevance and usefulness in a three-step evaluation study. J Antimicrob Chemother. 2018; https://doi.org/10.1093/jac/dky141.

Sevinç F, Prins JM, Koopmans RP, et al. Early switch from intravenous to oral antibiotics: guidelines and implementation in a large teaching hospital. J Antimicrob Chemother. 1999; https://doi.org/10.1093/jac/43.4.601.

Nathwani D, Lawson W, Dryden M, et al. Implementing criteria-based early switch/early discharge programmes: a European perspective. Clin Microbiol Infect. 2015; https://doi.org/10.1016/j.cmi.2015.03.023.

Avent ML, Lee XL, Irwin AD, et al. An innovative antimicrobial stewardship programme for children in remote and regional areas in Queensland, Australia: optimising antibiotic use through timely intravenous-to-oral switch. J Glob Antimicrob Resist. 2022; https://doi.org/10.1016/j.jgar.2021.11.014.

Desai M, Franklin BD, Holmes AH, et al. A new approach to treatment of resistant gram-positive infections: potential impact of targeted IV to oral switch on length of stay. BMC Infect Dis. 2006; https://doi.org/10.1186/1471-2334-6-94.

Parodi S, Rhew DC, Goetz MB. Early switch and early discharge opportunities in intravenous vancomycin treatment of suspected methicillin-resistant staphylococcal species infections. J Managed Care Pharm. 2003; https://doi.org/10.18553/jmcp.2003.9.4.317.

van Niekerk AC, Venter DJL, Bosch S-A. Implementation of intravenous to oral antibiotic switch therapy guidelines in the general medical wards of a tertiary-level hospital in South Africa. J Antimicrob Chemother. 2012; https://doi.org/10.1093/jac/dkr526.

Buyle FM, Metz-Gercek S, Mechtler R, et al. Prospective multicentre feasibility study of a quality of care indicator for intravenous to oral switch therapy with highly bioavailable antibiotics. J Antimicrob Chemother. 2012; https://doi.org/10.1093/jac/dks145.

Nathwani D, Eckmann C, Lawson CW, et al. Pan-European early switch/early discharge opportunities exist for hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections. CMI. 2014; https://doi.org/10.1111/1469-0691.12632.

McCarthy K, Avent M. Oral or intravenous antibiotics? Aust Prescr. 2020; https://doi.org/10.18773/austprescr.2020.008.

Dryden M, Saeed K, Townsend K, et al. Antibiotic stewardship and early discharge from hospital: impact of a structured approach to antimicrobial management. Antimicrob Chemother. 2012; https://doi.org/10.1093/jac/dks193.

Srinivas NR. Intravenous-to-oral switch in antimicrobial therapy: clinical pharmacology considerations and perspectives. Future Microbiol. 2017; https://doi.org/10.2217/fmb-2017-0075.

• Halouska MA, Van Roy ZA, Lang AN, et al. Excellent outcomes with the selective use of oral antibiotic therapy for bone and joint infections: a single-center experience. Cureus. 2022; https://doi.org/10.7759/cureus.26982. A single-center retrospective analysis of adults with the first episode of surgically managed osteomyelitis, native joint septic arthritis, prosthetic joint infection, or other musculoskeletal hardware infection was conducted. The patients were evaluated for treatment failure at one year and two years following their index surgery. The consensus criteria for switching to oral antibiotics for musculoskeletal infections identified patients who achieved excellent outcomes at one year and two years.

Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2009 https://doi.org/10.1086/599376.

Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2015; https://doi.org/10.1161/CIR.0000000000000296.

Habib G, Lancellotti P, Antunes MJ, et al. ESC guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;2015 https://doi.org/10.1093/eurheartj/ehv319.

Al-Omari A, Cameron DW, Lee C, Corrales-Medina VF. Oral antibiotic therapy for the treatment of infective endocarditis: a systematic review. BMC Infect Dis. 2014; https://doi.org/10.1186/1471-2334-14-140.

Cortés-Penfield NW, Kulkarni PA. The history of antibiotic treatment of osteomyelitis. Open Forum Infect Dis. 2019; https://doi.org/10.1093/ofid/ofz181.

• Li H-K, Rombach I, Zambellas R, et al. Oral versus intravenous antibiotics for bone and joint infection. N Engl J Med. 2019; https://doi.org/10.1056/NEJMoa1710926. A randomized trial included adults undergoing treatment for bone or joint infection at 26 UK centers. The study observed that oral antibiotic therapy was noninferior to intravenous antibiotic therapy when utilized during the initial 6 weeks for complex orthopedic infections.

• Boclé H, Lavigne J-P, Cellier N, et al. Effectiveness of early switching from intravenous to oral antibiotic therapy in Staphylococcus aureus prosthetic bone and joint or orthopedic metalware-associated infections. BMC Musculoskelet Dis. 2021; https://doi.org/10.1186/s12891-021-04191-y. A retrospective study analyzed cases of S. aureus prosthetic bone and joint or orthopedic metalware-associated infection. The study observed a low treatment failure rate with an early switch from intravenous to oral antibiotic therapy.

Geber JS, Jackson MA, Tamma PD, Zaoutis TE. Antibiotic stewardship in pediatrics. J Pediatrics Infec Dis Soc. 2021; https://doi.org/10.1542/peds.2020-040295.

McMullan BJ, Mahony M, Java L, et al. Improving intravenous-to-oral antibiotic switch in children: a team-based audit and implementation approach. BMJ Open Q. 2021; https://doi.org/10.1136/bmjoq-2020-001120.

Elemraid MA, Rushoton SP, Thomas MF, et al. Changing clinical practice: management of paediatric community-acquired pneumonia. J Eval Clin Pract. 2014; https://doi.org/10.1111/jep.12091.

• Keij FM, Kornelisse RF, Hartwig NG, et al. Efficacy and safety of switching from intravenous to oral antibiotics (amoxicillin–clavulanic acid) versus a full course of intravenous antibiotics in neonates with probable bacterial infection (RAIN): a multicentre, randomised, open-label, non-inferiority trial. Lancet Child Adolesc Health. 2022; https://doi.org/10.1016/S2352-4642(22)00245-0. In a multicentre randomized trial, neonates for whom prolonged antibiotic treatment was indicated were selected. They were randomly assigned to either switch to an oral suspension of amoxicillin 75 mg/kg plus clavulanic acid or continue on intravenous antibiotics. The study observed that an early intravenous-to-oral antibiotic switch is non-inferior to a full course of intravenous antibiotics and is not associated with an increased incidence of adverse events.

• Carlsen ELM, Dungu KHS, Lewis A, et al. Switch from intravenous-to-oral antibiotics in neonatal probable and proven early-onset infection: a prospective population-based real-life multicentre cohort study. Arch Dis Child Fetal Neonatal. 2023; https://doi.org/10.1136/archdischild-2023-325386. A multicentre cohort study was conducted to evaluate the implementation of a switch from intravenous to oral antibiotic therapy with amoxicillin in neonates with early-onset infection. The study observed that switch therapy was safe and utilized in 9 out of 10. Neonates.

Hikmat S, Lawrence J, Gwee A. Short intravenous antibiotic courses for urinary infections in young infants: a systematic review. Pediatrics. 2022; https://doi.org/10.1542/peds.2021-052466.

Keij FM, Kornelisse RF, Hartwig NG, et al. Oral antibiotics for neonatal infections: a systematic review and meta-analysis. J Antimicrob Chemother. 2019; https://doi.org/10.1093/jac/dkz252.

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