CP-139 Early switch from intravenous to oral antibiotics

• Published in: European journal of hospital pharmacy. Science and practice Vol. 23; no. Suppl 1; p. A61
• Main Authors: Laustsen, KS, Christensen, ST, Arpi, M, Boel, JB, Thygesen, L, Skovsted, LB
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01-03-2016
• Subjects: Antibiotics; Intervention; Intravenous therapy; Patients; Pharmacists
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2016-000875.139

BackgroundMany people hospitalised with infections are initially given intravenous antibiotics. The duration of intravenous therapy is often longer than necessary. Guidelines and interventions are needed to reduce unnecessary duration of intravenous therapy by an earlier switch to oral therapy.PurposeThe objective of this study was to evaluate the impact of pharmacist led intervention based on an early switch intravenous to oral guideline.Material and methodsThe quality improvement study was performed from January to September 2015 at the department of urology. Baseline data and intervention data were collected daily.The guideline was developed by a multidisciplinary team, including members of the antibiotic stewardship team, a doctor from the surgery ward and pharmacists. The guideline was based on already implemented guidelines combined with selected criteria from the early warning score.Abstract CP-139 Table 1Criteria in the early switch intravenous to oral guidelineGuideline for intravenous to oral switchIntravenous therapy ≥ 24 hVital measures:Temperature <38°CPulse ≤110Blood pressure >100Saturation >90%No gastrointestinal problemsNo problem with oral intakeNormalised/decreased C reactive protein (CRP)Normalised/decreased leukocyte countsPatients were registered daily if they were treated with intravenous and/or oral antibiotics. The patient was included in the study if all criteria in the guideline were met. The pharmacist intervened by a suggestion of switch from intravenous to oral therapy with a written note in the medical record and through an oral dialogue with the responsible nurse.ResultsDuring the intervention period from May to the end of September 2015, 239 patients were included based on the criteria of intravenous therapy ≥24 h. 38% (n = 91) of patients met all of the criteria and were suggested to switch to oral antibiotics. 56% of the interventions (n = 95) were accepted.Compared with baseline (0.59), a reduction of 8% points in the proportion of patients receiving intravenous therapy was seen in the intervention period (0.51).ConclusionA pharmacist led intervention had a measurable impact on the reduced proportion of patient receiving intravenous antibiotic therapy.No conflict of interest.