Early switching of antibiotic therapy from intravenous to oral using a combination of education, pocket-sized cards and switch advice: A practical intervention resulting in reduced length of hospital stay
•The impact of a combination of interventions to promote an early switch from intravenous (IV) to oral antibiotic was studied.•The median length of IV therapy decreased by 2 days due to the interventions.•Substantial cost savings and reduced length of hospital stay were achieved with the interventio...
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Veröffentlicht in: | International journal of antimicrobial agents 2020-01, Vol.55 (1), p.105769-105769, Article 105769 |
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container_title | International journal of antimicrobial agents |
container_volume | 55 |
creator | Mouwen, A.M.A. Dijkstra, J.A. Jong, E. Buijtels, P.C.A.M. Pasker-de Jong, P.C.M. Nagtegaal, J.E. |
description | •The impact of a combination of interventions to promote an early switch from intravenous (IV) to oral antibiotic was studied.•The median length of IV therapy decreased by 2 days due to the interventions.•Substantial cost savings and reduced length of hospital stay were achieved with the interventions.
To assess the effectiveness of a combined intervention on the timing and rate of switching from intravenous (IV) to oral antibiotic therapy.
The study used a historically-controlled prospective intervention design. Interventions consisted of educating physicians, handing out pocket-sized cards and providing switch advice in the electronic patient record (EPR). All patients hospitalized at the surgery department who were treated with IV antibiotics for at least 24 h and who fulfilled the switch criteria within 72 h of IV treatment were included. Outcomes before and during the intervention were compared.
An early IV to oral switch took place in 35.4% (35/99) of the antibiotic courses in the baseline period and in 67.7% (42/62) of the antibiotic courses in the intervention period (odds ratio [OR] 3.84, 95% confidence interval [CI] 1.96–7.53). Duration of IV therapy was significantly reduced from 5 to 3 days (P |
doi_str_mv | 10.1016/j.ijantimicag.2019.07.020 |
format | Article |
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To assess the effectiveness of a combined intervention on the timing and rate of switching from intravenous (IV) to oral antibiotic therapy.
The study used a historically-controlled prospective intervention design. Interventions consisted of educating physicians, handing out pocket-sized cards and providing switch advice in the electronic patient record (EPR). All patients hospitalized at the surgery department who were treated with IV antibiotics for at least 24 h and who fulfilled the switch criteria within 72 h of IV treatment were included. Outcomes before and during the intervention were compared.
An early IV to oral switch took place in 35.4% (35/99) of the antibiotic courses in the baseline period and in 67.7% (42/62) of the antibiotic courses in the intervention period (odds ratio [OR] 3.84, 95% confidence interval [CI] 1.96–7.53). Duration of IV therapy was significantly reduced from 5 to 3 days (P<0.01). Length of hospitalization was reduced from 6 to 5 days (P<0.05).
The interventions were effective in promoting an early IV to oral antibiotic switch by shortening the length of IV therapy and hospital stay.</description><identifier>ISSN: 0924-8579</identifier><identifier>EISSN: 1872-7913</identifier><identifier>DOI: 10.1016/j.ijantimicag.2019.07.020</identifier><identifier>PMID: 31362046</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>antibiotics ; antimicrobial stewardship ; guidelines ; hospital ; switch therapy</subject><ispartof>International journal of antimicrobial agents, 2020-01, Vol.55 (1), p.105769-105769, Article 105769</ispartof><rights>2019 Elsevier B.V. and International Society of Chemotherapy</rights><rights>Copyright © 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c377t-d8dc1913d764cac1ba25390dcedc5fcb96732cdb3f4842e5859e10880471041c3</citedby><cites>FETCH-LOGICAL-c377t-d8dc1913d764cac1ba25390dcedc5fcb96732cdb3f4842e5859e10880471041c3</cites><orcidid>0000-0002-8912-9892</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijantimicag.2019.07.020$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31362046$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mouwen, A.M.A.</creatorcontrib><creatorcontrib>Dijkstra, J.A.</creatorcontrib><creatorcontrib>Jong, E.</creatorcontrib><creatorcontrib>Buijtels, P.C.A.M.</creatorcontrib><creatorcontrib>Pasker-de Jong, P.C.M.</creatorcontrib><creatorcontrib>Nagtegaal, J.E.</creatorcontrib><title>Early switching of antibiotic therapy from intravenous to oral using a combination of education, pocket-sized cards and switch advice: A practical intervention resulting in reduced length of hospital stay</title><title>International journal of antimicrobial agents</title><addtitle>Int J Antimicrob Agents</addtitle><description>•The impact of a combination of interventions to promote an early switch from intravenous (IV) to oral antibiotic was studied.•The median length of IV therapy decreased by 2 days due to the interventions.•Substantial cost savings and reduced length of hospital stay were achieved with the interventions.
To assess the effectiveness of a combined intervention on the timing and rate of switching from intravenous (IV) to oral antibiotic therapy.
The study used a historically-controlled prospective intervention design. Interventions consisted of educating physicians, handing out pocket-sized cards and providing switch advice in the electronic patient record (EPR). All patients hospitalized at the surgery department who were treated with IV antibiotics for at least 24 h and who fulfilled the switch criteria within 72 h of IV treatment were included. Outcomes before and during the intervention were compared.
An early IV to oral switch took place in 35.4% (35/99) of the antibiotic courses in the baseline period and in 67.7% (42/62) of the antibiotic courses in the intervention period (odds ratio [OR] 3.84, 95% confidence interval [CI] 1.96–7.53). Duration of IV therapy was significantly reduced from 5 to 3 days (P<0.01). Length of hospitalization was reduced from 6 to 5 days (P<0.05).
The interventions were effective in promoting an early IV to oral antibiotic switch by shortening the length of IV therapy and hospital stay.</description><subject>antibiotics</subject><subject>antimicrobial stewardship</subject><subject>guidelines</subject><subject>hospital</subject><subject>switch therapy</subject><issn>0924-8579</issn><issn>1872-7913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqNkc2O0zAURi0EYsrAKyCzY0GC7fw4YTeqBgZpJDawtpzrm9YliYPtFJVn5KFwph3EkpV1pfudI9-PkDec5Zzx-v0htwc9RTta0LtcMN7mTOZMsCdkwxspMtny4inZsFaUWVPJ9oq8COHAGK-KsnpOrgpe1IKV9Yb8vtV-ONHw00bY22lHXU9XdGddtEDjHr2eT7T3bqR2il4fcXJLoNFR5_VAl7CGNAU3dnbS0bppRaBZ4GF4R2cH3zFmwf5CQ0F7E5LAXIxUm6MF_EBv6Ow1JGViJg_65HmAeQzLEFeJXYfETZgBp13cr6K9C7ONKRSiPr0kz3o9BHx1ea_Jt4-3X7d32f2XT5-3N_cZFFLGzDQGeLqQkXUJGninRVW0zCQyVD10bS0LAaYr-rIpBVZN1SJnTcNKyVnJobgmb8_c2bsfC4aoRhsAh0FPmI6jhKhlyWTDWVptz6vgXQgeezV7O2p_UpyptUx1UP-UqdYyFZMqlZmyry-apRvR_E0-tpcWtucFTJ89WvQqgMUp_cN6hKiMs_-h-QOVFbxU</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Mouwen, A.M.A.</creator><creator>Dijkstra, J.A.</creator><creator>Jong, E.</creator><creator>Buijtels, P.C.A.M.</creator><creator>Pasker-de Jong, P.C.M.</creator><creator>Nagtegaal, J.E.</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8912-9892</orcidid></search><sort><creationdate>202001</creationdate><title>Early switching of antibiotic therapy from intravenous to oral using a combination of education, pocket-sized cards and switch advice: A practical intervention resulting in reduced length of hospital stay</title><author>Mouwen, A.M.A. ; Dijkstra, J.A. ; Jong, E. ; Buijtels, P.C.A.M. ; Pasker-de Jong, P.C.M. ; Nagtegaal, J.E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c377t-d8dc1913d764cac1ba25390dcedc5fcb96732cdb3f4842e5859e10880471041c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>antibiotics</topic><topic>antimicrobial stewardship</topic><topic>guidelines</topic><topic>hospital</topic><topic>switch therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mouwen, A.M.A.</creatorcontrib><creatorcontrib>Dijkstra, J.A.</creatorcontrib><creatorcontrib>Jong, E.</creatorcontrib><creatorcontrib>Buijtels, P.C.A.M.</creatorcontrib><creatorcontrib>Pasker-de Jong, P.C.M.</creatorcontrib><creatorcontrib>Nagtegaal, J.E.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of antimicrobial agents</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mouwen, A.M.A.</au><au>Dijkstra, J.A.</au><au>Jong, E.</au><au>Buijtels, P.C.A.M.</au><au>Pasker-de Jong, P.C.M.</au><au>Nagtegaal, J.E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early switching of antibiotic therapy from intravenous to oral using a combination of education, pocket-sized cards and switch advice: A practical intervention resulting in reduced length of hospital stay</atitle><jtitle>International journal of antimicrobial agents</jtitle><addtitle>Int J Antimicrob Agents</addtitle><date>2020-01</date><risdate>2020</risdate><volume>55</volume><issue>1</issue><spage>105769</spage><epage>105769</epage><pages>105769-105769</pages><artnum>105769</artnum><issn>0924-8579</issn><eissn>1872-7913</eissn><abstract>•The impact of a combination of interventions to promote an early switch from intravenous (IV) to oral antibiotic was studied.•The median length of IV therapy decreased by 2 days due to the interventions.•Substantial cost savings and reduced length of hospital stay were achieved with the interventions.
To assess the effectiveness of a combined intervention on the timing and rate of switching from intravenous (IV) to oral antibiotic therapy.
The study used a historically-controlled prospective intervention design. Interventions consisted of educating physicians, handing out pocket-sized cards and providing switch advice in the electronic patient record (EPR). All patients hospitalized at the surgery department who were treated with IV antibiotics for at least 24 h and who fulfilled the switch criteria within 72 h of IV treatment were included. Outcomes before and during the intervention were compared.
An early IV to oral switch took place in 35.4% (35/99) of the antibiotic courses in the baseline period and in 67.7% (42/62) of the antibiotic courses in the intervention period (odds ratio [OR] 3.84, 95% confidence interval [CI] 1.96–7.53). Duration of IV therapy was significantly reduced from 5 to 3 days (P<0.01). Length of hospitalization was reduced from 6 to 5 days (P<0.05).
The interventions were effective in promoting an early IV to oral antibiotic switch by shortening the length of IV therapy and hospital stay.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>31362046</pmid><doi>10.1016/j.ijantimicag.2019.07.020</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-8912-9892</orcidid></addata></record> |
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subjects | antibiotics antimicrobial stewardship guidelines hospital switch therapy |
title | Early switching of antibiotic therapy from intravenous to oral using a combination of education, pocket-sized cards and switch advice: A practical intervention resulting in reduced length of hospital stay |
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