Department of Clinical Pharmacy, Meander Medical Center, Amersfoort, The Netherlands.
Department of Internal Medicine, Meander Medical Center, Amersfoort, The Netherlands.
Int J Antimicrob Agents. 2020 Jan;55(1):105769. doi: 10.1016/j.ijantimicag.2019.07.020. Epub 2019 Jul 27.
To assess the effectiveness of a combined intervention on the timing and rate of switching from intravenous (IV) to oral antibiotic therapy.
The study used a historically-controlled prospective intervention design. Interventions consisted of educating physicians, handing out pocket-sized cards and providing switch advice in the electronic patient record (EPR). All patients hospitalized at the surgery department who were treated with IV antibiotics for at least 24 h and who fulfilled the switch criteria within 72 h of IV treatment were included. Outcomes before and during the intervention were compared.
An early IV to oral switch took place in 35.4% (35/99) of the antibiotic courses in the baseline period and in 67.7% (42/62) of the antibiotic courses in the intervention period (odds ratio [OR] 3.84, 95% confidence interval [CI] 1.96-7.53). Duration of IV therapy was significantly reduced from 5 to 3 days (P<0.01). Length of hospitalization was reduced from 6 to 5 days (P<0.05).
The interventions were effective in promoting an early IV to oral antibiotic switch by shortening the length of IV therapy and hospital stay.
评估联合干预措施对静脉（IV）向口服抗生素治疗转换的时机和速度的影响。
本研究采用了历史对照前瞻性干预设计。干预措施包括教育医生、发放袖珍卡片以及在电子病历（EPR）中提供转换建议。所有在外科病房住院、静脉使用抗生素治疗至少 24 小时且在静脉治疗后 72 小时内符合转换标准的患者均被纳入研究。比较干预前后的结果。
在基线期，35.4%（35/99）的抗生素疗程发生了早期 IV 到口服的转换，而在干预期，67.7%（42/62）的抗生素疗程发生了转换（比值比[OR]3.84，95%置信区间[CI]1.96-7.53）。IV 治疗的持续时间从 5 天显著缩短至 3 天（P<0.01）。住院时间从 6 天缩短至 5 天（P<0.05）。
这些干预措施通过缩短 IV 治疗和住院时间，有效地促进了早期 IV 到口服抗生素的转换。
