Pharmacy World and Science

, Volume 24, Issue 6, pp 247–255 | Cite as

Intravenous and oral antibiotics in respiratory tract infection: an international observational study of hospital practice

  • J. CookeEmail author
  • T. Morris
  • M. Kubin
  • J. Ribas
  • I. Krämer
  • I. Kämmerer
  • R. Fornani
  • A.‐C. Ballet
  • P.‐P. Sagnier


Background: Hospitalised patients with respiratory tract infections (RTI) frequently receive intravenous %lpar;IV) antibiotics followed by a short course of oral treatment.Objectives: To observe antibiotic use in hospitals in Germany, Spain, France, Italy and the UK and the reasons for choosing the IV route and switching to oral treatment. Methods: Research pharmacists sought the opinions of physicians and senior nurses in the completion of a semi-structured questionnaire on the treatment of RTI with IV antibiotics. Questions focussed on antimicrobials of choice, reasons for choosing IV, reasons for changing to oral administration, and duration of treatment.Results: This study recruited 796 patients with RTI, usually pneumonia. Prescribing patterns varied widely between the five hospitals. Accepted clinical criteria were only commonly cited in Germany, Spain and the UK as reasons for choosing the IV route at the beginning of the study. These were more commonly cited at the time of switch, although other criteria such as improved condition, were other significant reasons. The mean duration of IV treatment ranged from 4 days in the UK to 10 days in Italy, where most patients received the full course of treatment by the IV route. Unlike the other hospitals studied, the few patients in Italy who were switched to another form of treatment were as likely to receive intramuscular as oral administration (13% and 11%, respectively). Conclusions: The practice of and reasons for prescribing IV antibiotics varied in the hospitals studied. Objective clinical criteria were inconsistently cited as reasons for administering IV antibiotics and in general these reasons were unrelated to those given for the switch from IV to oral administration. In order for guidelines for switching from IV to oral antimicrobials to be routinely employed, explicit physiological criteria need to be recorded in a routine fashion. Closer co‐operation between pharmacists and physicians may help in developing and implementing guidelines at a local level.

Antibiotics Hospital pharmacy Intravenous antibiotics Observational study Oral antibiotics Respiratory tract infection Switch therapy 


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Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • J. Cooke
    • 1
    Email author
  • T. Morris
    • 1
  • M. Kubin
    • 2
  • J. Ribas
    • 3
  • I. Krämer
    • 4
  • I. Kämmerer
    • 5
  • R. Fornani
    • 6
  • A.‐C. Ballet
    • 7
  • P.‐P. Sagnier
    • 8
  1. 1.South Manchester University Hospitals NHS TrustWithington HospitalManchesterUK
  2. 2.Health Economics and Outcomes ResearchBayer VitalLeverkusenGermany
  3. 3.Hospital Clinic I ProvincialBarcelonaSpain
  4. 4.Johannes-Gutenberg UniverstätMainzGermany
  5. 5.Dr Horst Schmidt KlinikenWiesbadenGermany
  6. 6.Ospedale CareggiFlorenceItaly
  7. 7.Centre Hospitalier Universitaire de BordeauxFrance
  8. 8.Health Economics and Outcomes ResearchBayer plcSloughUK

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