Practice of Intravenous to Oral Conversion of Antibiotics and its Influence on Length of Stay at a Tertiary Care Hospital: A Prospective Study

Abstract

Introduction: Several studies have demonstrated the efficacy and safety of switching from intravenous to oral antibiotics in clinically stable patients. Early switch from Intravenous (IV) to Per Oral (PO) could be one of the factors that influence the Length of Hospital Stay (LOHS). Aim: To evaluate the practice of switch from intravenous to oral antibiotics and its impact on the LOHS at a tertiary care hospital. Materials and Methods: A prospective observational study was conducted over a period of six months from November 2015 to April 2016. The practice of conversion from IV to PO antibiotic therapy was assessed according to predefined criteria for clinical stability. Clinical end points such as day of IV to PO switch, LOHS and duration of antibiotic therapy were assessed. Results: Results reveal that 43.68% of antibiotics were converted from IV to oral formulation while 56.32% of antibiotic courses were not converted from IV to oral. Out of all IV to oral conversions, sequential therapy was more commonly used than switch and step-down therapy. LOHS for patients had significantly (p<0.05) decreased following IV to oral conversion of antibiotics in comparison to LOHS for patients with non conversion of antibiotics from IV to oral formulation. Day of conversion was more delayed in switch therapy than two other modes of conversion. Conclusion: Timely switching of antibiotics from IV to oral therapy could reduce the length of hospitalisation for patients.

Keywords

• intravenous to oral switch
• sequential therapy
• step-down therapy