Evaluation of an antibiotic intravenous to oral sequential therapy program

Pablos, Ana I.; Escobar, Ismael; Albiñana, Sandra; Serrano, Olga López; Ferrari, José Miguel; Tejada, Alberto Herreros de

doi:10.1002/pds.1042

Cited by 16 publications

(12 citation statements)

References 12 publications

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“…34 Where details of the strategies used to achieve this were given, one-third of Trusts had restricted iv ciprofloxacin and advocated early switch to the much cheaper oral form. This is a welldescribed intervention: [35][36][37] the high bioavailability of oral ciprofloxacin may give pharmacists confidence in making this switch, and therefore makes a good target for an initial antimicrobial intervention in Trusts where there had previously been little activity in this area. However, such savings cannot be assumed to be recurrent; in Trusts where specialist staff have been employed in Pharmacy for some time, cost savings may be high initially, and then tail off as the 'easy targets' are exhausted.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Hospital Pharmacy Initiative for promoting prudent use of antibiotics in hospitals in England

Wickens¹,

Jacklin

2006

Journal of Antimicrobial Chemotherapy

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, the UK Department of Health announced an allocation of £12 million to hospital pharmacists to improve the monitoring and control of anti-infective use over the ensuing 3 year period (the Hospital Pharmacy Initiative, or HPI). Chief Pharmacists were asked to use this money for developments to promote prudent antibiotic use and monitoring of antimicrobials within their Trusts. This study aimed to evaluate the impact of the HPI funding, which at the time had been in place for nearly 2 years, on pharmacy activities in this area.Methods: A postal questionnaire was sent to the pharmacy department of each acute hospital Trust in England, aiming to provide a descriptive overview of the activities of hospital pharmacy staff in the field of anti-infectives and to explore the extent to which these activities were made possible by the HPI funding.Results: One hundred and forty-one specialist antimicrobial pharmacy staff were employed in 130 responding Trusts; 89% were pharmacists, 7% pharmacy technicians and the remainder administrative staff. Three-quarters of these staff had been employed due to the funding, resulting in review of antimicrobial prescribing guidelines, antibiotic audit projects and multidisciplinary work with Microbiology/Infectious Diseases staff. Thirteen Trusts gave details of drug acquisition cost savings; over the course of a year, these Trusts saved £1.1 million in total. Conclusions:The HPI funding has facilitated greater interaction between Pharmacy and Microbiology/ Infectious Diseases departments than was previously possible. Significant reductions in antibiotic acquisition costs have been demonstrated, though further work is warranted to fully establish the impact of pharmacy activities on clinical and microbiological outcomes.

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Section: Discussionmentioning

confidence: 99%

Impact of the Hospital Pharmacy Initiative for promoting prudent use of antibiotics in hospitals in England

Wickens¹,

Jacklin

2006

Journal of Antimicrobial Chemotherapy

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“…Alternatively, there are some oral antibiotics that have a high bioavailability, thus the equivalent IV formulation appears costly to use with no extra clinical benefit. Sequential therapy programmes have been undertaken with quinolones for this reason showing that significant cost savings can be made by reducing the usage of IV formulations by 60% . In this study, the IV route was reserved only for the seriously ill or those with intestinal diseases that prevented sufficient oral absorption.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic intravenous-to-oral switch guidelines: barriers to adherence and possible solutions

Warburton

Hodson

James

2014

International Journal of Pharmacy Practice

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Objectives To identify reasons for poor adherence to antibiotic intravenous‐to‐oral switch guidelines and to explore the possible solutions. To rate the importance of the barriers and solutions identified, as perceived by a multidisciplinary expert panel. Methods Three‐round Delphi study in an expert panel comprising doctors, nurses and pharmacists, with concurrent semi‐structured interviews. Key findings The three rounds of the Delphi were completed by 13 out of the 30 healthcare professionals invited to participate. No nurses were included in the final round. Consensus was achieved for 28 out of 35 statements, with the most important barrier being that of inappropriate antibiotic review at the weekend, and the most important solution being to raise guideline awareness. The findings from the seven interviews (three doctors, two pharmacists and two nurses) complemented those from the Delphi study, although they provided more specific suggestions on how to improve the adherence to guidelines. Conclusion This study, using a combination of quantitative and qualitative methods, has identified several barriers to explore further and offered many practical solutions to improve practice. The importance of a multidisciplinary approach to address guideline non‐adherence was emphasised. Clinical guidelines must be well publicised and well written to prevent a feeling of guideline saturation in the healthcare populous. Novel approaches may have to be investigated in order to further encourage adherence with antibiotic intravenous‐to‐oral switch guidelines.

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“…The over 20 times more expensive intravenous therapy means a considerable additional economic burden for the department without increasing effectivity. A series of other clinical studies has shown that changing antibiotic therapy from intravenous to oral administration considerably lowers the costs for this drug therapy with the same treatment success [10,21].…”

Section: Discussionmentioning

confidence: 99%

Oral vs intravenous antibiotic prophylaxis in elective laparoscopic cholecystectomy—an exploratory trial

Zurbuchen

Ritz

Lehmann

et al. 2007

Langenbecks Arch Surg

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Evaluation of an antibiotic intravenous to oral sequential therapy program

Cited by 16 publications

References 12 publications

Impact of the Hospital Pharmacy Initiative for promoting prudent use of antibiotics in hospitals in England

Impact of the Hospital Pharmacy Initiative for promoting prudent use of antibiotics in hospitals in England

Antibiotic intravenous-to-oral switch guidelines: barriers to adherence and possible solutions

Oral vs intravenous antibiotic prophylaxis in elective laparoscopic cholecystectomy—an exploratory trial

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