4CPS-140 Impact of oral sequential therapy on antimicrobial prescribing at a tertiary care hospital
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance Oral sequential therapy (OST) consists of switching parenteral antibiotherapy to oral antimicrobials, with the aim to reduce complications associated with parenteral administration, hospital stay times, treatment duration (TD) and costs. Aim and Objectives To describe OST recommendations and its acceptance degree by prescribers. To analyse the impact on inpatient antimicrobial consumption following the OST implementation. Material and Methods Descriptive, observational, cross-sectional and prospective study of inpatient ‘OST’ interventions from 11/2023 to 01/2024 inclusive. In addition, hospital antimicrobial consumption data are recorded in 11/2022–01/2023 (‘pre-OST’) and 11/2023–01/2024 (‘post-OST’). Data included: age, diagnosis, administration route, TD, interventions and antimicrobial consumption. Inclusion criteria: parenteral therapy, antimicrobial with oral bioavailability≥60% and TD≥3 days. Exclusion criteria: oral intolerance, sepsis/complicated infections, rising acute phase reactants, altered consciousness, fever and/or haemodynamic instability. Results 110 inpatients met the inclusion criteria in the study period {median age of 77 years [interquartile range:(68,88)]}. After applying exclusion criteria [oral intolerance (27 cases), sepsis/complicated infection (24), rising acute phase reactants (16), altered consciousness (1), fever (1)], OST was recommended to 41 inpatients. The acceptance rate was 85.4% (35/41). The action of prescribers after acceptance was: Parenteral to oral antibiotherapy switch during hospitalisation: 74.3%(26 interventions/35 accepted). Discontinuation of antibiotherapy and hospital discharge: 14.3%(5/35). Discontinuation of antibiotherapy, continuing hospitalisation: 8.6%(3/35). Hospital discharge with oral antibiotherapy for home use: 2.8%(1/35). The most recorded antimicrobial was levofloxacin (29/41:70.7%), followed by isavuconazole and amoxicillin/clavulanate (4/41:9.8% in both cases); their hospital consumption was (table 1): Conclusion and Relevance Despite of limited sampling size and strict exclusion criteria, a high acceptance degree (>85%) was obtained, also a parenteral therapy reduction and an oral increase was recorded with levofloxacin and isavuconazole. Some acceptances resulted in antibiotherapy discontinuation and/or hospital discharge. Further studies are required to demonstrate advantages like reducing complications associated with parenteral administration, hospital stay times and costs. References and/or Acknowledgements Conflict of Interest No conflict of interest
Institution: Hospital San Pedro de Alcántara
Language: English
Subfield: Applied Microbiology and Biotechnology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
OpenAlex ID: W4408376965