Department of Pharmacy, Austin Health, Melbourne, Victoria, Australia.
Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia.
Br J Clin Pharmacol. 2021 Aug;87(8):3354-3358. doi: 10.1111/bcp.14734. Epub 2021 Jan 23.
Timely intravenous (IV) to oral antimicrobial switch (IV-oral-switch) is a key antimicrobial stewardship (AMS) strategy. We aimed to explore concordance with IV-oral-switch guidelines in the context of a long-standing, tightly regulated AMS program. Data was retrospectively collected for 107 adult general medical and surgical patients in an Australian hospital. Median duration of IV antimicrobial courses before switching to oral therapy was 3 days (interquartile range [IQR] 2.25-5.00). Timely IV-oral-switch occurred in 57% (n = 61) of patients. The median delay to switching was 0 days (IQR 0 to 1.25). In most courses (92/106, 86.8%), the choice of oral alternative after switching was appropriate. In 45% (47/105) of courses, total duration of therapy (IV plus oral) exceeded the recommended duration by >1.0 day. Excessive IV antimicrobial duration was uncommon at a hospital with a tightly regulated AMS program. Total duration of therapy was identified as an AMS target for improvement.
及时进行静脉（IV）到口服抗菌药物转换（IV-口服转换）是抗菌药物管理（AMS）的关键策略。我们旨在探讨在长期严格监管的 AMS 计划背景下，与 IV-口服转换指南的一致性。该研究回顾性收集了澳大利亚一家医院 107 例成年普通内科和外科患者的数据。在开始口服治疗前，静脉抗菌药物疗程的中位数为 3 天（四分位距 [IQR] 2.25-5.00）。57%（n=61）的患者及时进行了 IV-口服转换。转换的中位延迟为 0 天（IQR 0 至 1.25）。在大多数疗程（92/106，86.8%）中，转换后的口服替代药物选择是合适的。在 45%（47/105）的疗程中，治疗总时长（IV 加口服）超过了推荐时长>1.0 天。在一个有严格 AMS 计划监管的医院中，静脉抗菌药物疗程过长的情况并不常见。治疗总时长被确定为 AMS 需要改进的目标。
