Journal of Antimicrobial Chemotherapy, Vol 42, 107-111, Copyright © 1998 by The British Society for Antimicrobial Chemotherapy
RB Laing, AR Mackenzie, H Shaw, IM Gould and JG Douglas
The effect of an intravenous (i.v.)-to-oral switch policy on antibiotic
prescribing in general medical wards was examined. Three audits, each of 2
months' duration, were carried out to examine the duration of i.v. therapy
and length of patient stay. The first audit (S1) was performed before the
introduction of switch guidelines, the second (S2) after guidelines had
been placed in patient case-notes and the third (S3) after the guidelines
had been introduced into the drug charts. The duration of i.v. therapy was
significantly shorter in the S3 group (mean = 3.7 days) than in the S2 or
S1 groups (mean 4.4 and 4.35 days, respectively) (P < 0.05). There was
no significant difference in the length of patient stay between the three
audit periods but the stay was significantly shorter in 81 switched
patients (mean duration = 8.9 days) than in matched controls (mean duration
= 12.6 days) (P = 0.01). Fewer patients with respiratory infection were
treated for > 24 h with i.v. antimicrobials in the S3 audit period
(75/549) than in the S2 (85/372) and S1 audits (83/326) (P < 0.01). The
introduction of switch guidelines to drug charts reduces the length of i.v.
therapy. Switched patients spend less time in hospital than their matched
controls.
ORIGINAL ARTICLES
The effect of intravenous-to-oral switch guidelines on the use of parenteral antimicrobials in medical wards
Infection Unit, Aberdeen Royal Infirmary, Foresterhill, UK.
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