Journal of Antimicrobial Chemotherapy (2000) 45, 724-727
© 2000 The British Society for Antimicrobial Chemotherapy
Leading articles |
Outpatient parenteral treatment of bacterial infections: the Italian model as an international trend?
Department of Infectious Diseases, Second University of Naples, Ospedale Gesù e Maria, Via D. Cotugno 1, 80135 Naples, Italy
The choice of administration route for an antibiotic remains a fairly controversial matter, as confirmed by the variation in prescribing habits among different countries. This variation may result from difficulty in identifying standard criteria that would unequivocally indicate the necessity of oral or parenteral administration.1 In general, the decision to administer an antibiotic by the parenteral route is influenced by three main factors: (i) reduced gastrointestinal absorption in the patient; (ii) lack of appropriate oral antibiotics; and (iii) specific disease and related severity.
Although relatively rare, gastrectomy and short-bowel syndrome are the main gastrointestinal conditions that make oral administration impossible. Diarrhoea, nausea and vomiting are the most frequently observed gastrointestinal side effects that occur as a result of oral administration of an antibiotic; these disturbances can be responsible for impaired absorption.2 Such side effects vary greatly in incidence and intensity according to the class of antibiotic used, but they should
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