Hamilton-Miller J
Department of Medical Microbiology, Royal Free Hospital School of Medicine, London, UK.
Chemotherapy. 1998 Sep;44 Suppl 1:24-7. doi: 10.1159/000048460.
Switch therapy, or step-down therapy, is the concept of switching from an intravenous antibiotic to an oral preparation after a few days, once the condition of the patient has improved and the pathogen and its susceptibility have been determined. The orally active third-generation cephalosporin cefixime is a primary candidate for switch therapy owing to its very good efficacy and safety profile. Preliminary studies have shown excellent clinical outcomes with switch therapy to cefixime after 2-3 days for a variety of serious infections. Importantly, dramatic cost benefits have also been found, particularly with respect to reduced length of hospital stays. However, guidelines are required to indicate under what conditions switch therapy is appropriate, and awareness must be developed within hospitals among physicians, pharmacists and administrators alike.
转换疗法，即降阶梯疗法，是指在患者病情改善且病原体及其药敏情况已确定后，数天后从静脉用抗生素转换为口服制剂的概念。口服活性第三代头孢菌素头孢克肟因其良好的疗效和安全性，是转换疗法的主要候选药物。初步研究表明，对于各种严重感染，在2至3天后转换为头孢克肟进行治疗可取得优异的临床效果。重要的是，还发现了显著的成本效益，特别是在缩短住院时间方面。然而，需要有指南来指明在何种情况下转换疗法是合适的，并且医院内的医生、药剂师和管理人员都必须提高认识。
