BMC Infectious Diseases · 2019 · 65 citations · 18 references
PharmacyPharmacoeconomicsAntimicrobial PharmacotherapyAntimicrobial StewardshipSepsisAntimicrobial TherapyHospital Antimicrobial StewardshipIntensive Care MedicineIntravenous To Oral Switch PoliciesIntravenous-to-oral Switch TherapySepsis ManagementClinical Stability AssessmentIntensive Care Unit Antimicrobial StewardshipIntensive Care Unit StewardshipIntravenous To Oral Switch SupportIntravenous-to-oral Antibiotic SwitchOral Antibiotic TherapySepsis Antimicrobial StewardshipStewardship Intervention Implementation
BACKGROUND: This study aimed to evaluate the oral switch (OS) stewardship intervention in the intensive care unit (ICU). METHODS: This was a retrospective study with a convenience sample in two Brazilian ICUs from different hospitals in patients with sepsis receiving antibiotic therapy. The stewardship intervention included OS in patients diagnosed with sepsis when clinical stability was achieved. The primary outcome was overall mortality. Other variables evaluated were as follows: cost of antimicrobial treatment, daily costs of intensive care, acute kidney injury, and length of stay. RESULTS: There was no difference in mortality between the OS and non-OS groups (p = 0.06). Length of stay in the ICU (p = 0.029) was shorter and acute kidney injury incidence (p = 0.032) and costs of antimicrobial therapy (p < 0.001) were lower in the OS group. CONCLUSION: OS stewardship programs in the ICU may be considered a safe strategy. Switch therapy reduced the cost and shortened the length of stay in ICUs.
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André C. Kalil, Mark L. Metersky, Michael Klompas et al. · Clinical Infectious Diseases · 2016 · 3.9K citations · Full text
Joseph S. Solomkin, Harald H. Reinhart, E. Patchen Dellinger et al. · Annals of Surgery · 1996 · 191 citations · Full text