IV to PO Switch Guideline
N.B. as with all standard antibiotic
guidelines on this website, paediatric patients and adult patients with chemotherapy-related neutropenia
and/or bone marrow transplant patients are excluded.
-
The majority of patients with a
severe infection who are adequately absorbing oral medication and initially
require IV therapy can be safely switched to oral therapy within 48 hours with a
number of benefits.
-
Considerations for the early switch
to oral therapy "COMS". Patients should generally have all of the COMS
criteria.
-
Review at 24-48 hours after
starting IVs and then daily
C
|
Clinical improvement observed |
O
|
Oral route is not compromised vomiting, malabsorptive disorder, NBM,
swallowing problems, unconscious, severe diarrhoea)
Suitable oral
antibiotic option available (click here
for recommended oral switches)
NB: if NG/PEG feeding then please
consult your pharmacist |
M
|
Markers showing a trend towards normal:
Patient should be apyrexial for the last 24 hours (Temp>36oC
and <38oC) AND no more than one of the following,
- Heart rate >90/min,
- Respiratory rate >20/min,
- BP unstable,
- WCC <4 or>12 White cell count should show a trend towards
normal; absence of such should not impede the switch if all other
criteria are met and not neutropaenic.
|
S
|
Specific
indication/deep-seated infection |
Certain multi-resistant organisms often require treatment with agents that are
only available in an intravenous form, please seek
microbiology advice regarding the length of treatment.
|
