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Switch Therapy: What Should Be Considered in Patients Using Antimicrobials?

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Abstract

Purpose of Review As to update the eligibility

The goal of this review criteria for intravenous (IV) to oral (PO) antimicrobial switch therapy. By systematically revising the literature, we also aimed to highlight promising studies regarding the treatment of specific diseases and populations, in addition to identifying potential barriers to adherence to this practice.

Recent Findings

Recent studies have shown promising results in osteomyelitis, endocarditis, and Staphylococcus aureus bacteremia, which were previously not considered suitable for the switch from intravenous to oral therapy due to the assumption that these severe infections require higher amounts of antimicrobial drugs in the tissue and therefore must be treated via the IV route. Recent studies in pediatric and neonatal patients have also demonstrated the safe application of IV-to-PO switch therapy, with no increase in rehospitalization rates, along with a reduction in hospital costs due to shorter lengths of stay.

Summary

Medical literature touts numerous benefits to the practice, including reducing adverse reactions related to intravascular access, shorter hospital stays, and cost reduction. However, there remain many barriers to adherence. This article systematizes and structures the eligibility criteria for a safe transition from intravenous to oral antimicrobial therapy.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Acknowledgements

Julia Downey de Oliveira provided assistance with the translation.

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Authors and Affiliations

  1. Hospital Israelita Albert Einstein, São Paulo, Brazil

    Barbara Barduchi Oliveira da Silva PharmD, MSc, Alessandra Gomes Chauvin PharmD, Leandro Martins dos Santos PharmD, Gabrielli Pare Guglielmi PharmD & Silvana Maria de Almeida PharmD, MSc

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  1. Barbara Barduchi Oliveira da Silva PharmD, MSc
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  2. Alessandra Gomes Chauvin PharmD
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  3. Leandro Martins dos Santos PharmD
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Contributions

All authors contributed to the conception and design of the study. Barbara Barduchi Oliveira da Silva had the idea for the article, Gabrielli Pare Guglielmi, Alessandra Gomes Chauvin, and Leandro Martins dos Santos conducted the literature search and data analysis, Barbara Barduchi Oliveira da Silva drafted the work, and Silvana Maria de Almeida critically reviewed the work.

Corresponding author

Correspondence to Barbara Barduchi Oliveira da Silva PharmD, MSc.

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Barbara Barduchi Oliveira da Silva declares that she has no conflict of interest.

Alessandra Gomes Chauvin declares that she has no conflict of interest.

Leandro Martins dos Santos declares that he has no conflict of interest.

Gabrielli Pare Guglielmi declares that she has no conflict of interest.

Silvana Maria de Almeida declares that she has no conflict of interest.

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da Silva, B.B.O., Chauvin, A.G., dos Santos, L.M. et al. Switch Therapy: What Should Be Considered in Patients Using Antimicrobials?. Curr Treat Options Infect Dis 16, 1–13 (2024). https://doi.org/10.1007/s40506-023-00268-5

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