Author, as appears in the article.: Rodriguez-Pardo, D.; Pigrau, C.; Campany, D.; Diaz-Brito, V.; Morata, L.; de Diego, I. C.; Sorli, L.; Iftimie, S.; Perez-Vidal, R.; Garcia-Pardo, G.; Larrainzar-Coghen, T.; Almirante, B.;

Department: Medicina i Cirurgia

URV's Author/s: Iftimie Iftimie, Simona Mihaela

Keywords: Complicated skin Early discharge Guidelines Impact Implementation Iv Resistant staphylococcus-aureus Stewardship

Abstract: Switching from intravenous to oral antibiotic therapy may improve inpatient management and reduce hospital stays and the complications of intravenous treatment. We aimed to assess the effectiveness of intravenous-to-oral antibiotic switch therapy and an early discharge algorithm in hospitalized patients with gram-positive infection. We performed a prospective cohort study with a retrospective comparison cohort, recruited from eight tertiary, acute-care Spanish referral hospitals. All patients included had culture-confirmed methicillin-resistant gram-positive infection, or methicillin-susceptible gram-positive infection and beta-lactam allergy and had received intravenous treatment with glycopeptides, lipopeptides, or linezolid. The study comprised two cohorts: the prospective cohort to assess the effectiveness of a sequential intravenous-to-oral antibiotic switch algorithm and early discharge, and a retrospective cohort in which the algorithm had not been applied, used as the comparator. A total of 247 evaluable patients were included; 115 in the prospective and 132 in the retrospective cohort. Forty-five retrospective patients (34 %) were not changed to oral antibiotics, and 87 (66 %) were changed to oral antibiotics without following the proposed algorithm. The duration of hospitalization was significantly shorter in the prospective cohort compared to the retrospective group that did not switch to oral drugs (16.7 +/- 18.7 vs 23 +/- 13.4 days, P < 0.001). No differences were observed regarding the incidence of catheter-related bacteraemia (4.4 % vs 2.6 %, P = 0.621). Our results suggest that an intravenous-to-oral antibiotic switch strategy is effective for reducing the length of hospital stay in selected hospitalized patients with gram-positive infection.

Thematic Areas: Biodiversidade Biotecnología Ciências agrárias i Ciências ambientais Ciências biológicas i Ciências biológicas ii Ciências biológicas iii Educação física Farmacia Infectious diseases Interdisciplinar Medicina i Medicina ii Medicina veterinaria Medicine (miscellaneous) Microbiology Microbiology (medical) Odontología Saúde coletiva

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: simonamihaela.iftime@urv.cat simonamihaela.iftime@urv.cat

Author identifier: 0000-0003-0714-8414 0000-0003-0714-8414

Record's date: 2022-07-16

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://link.springer.com/article/10.1007/s10096-016-2661-5

Papper original source: European Journal Of Clinical Microbiology & Infectious Diseases. 35 (8): 1269-1276

APA: Rodriguez-Pardo, D.; Pigrau, C.; Campany, D.; Diaz-Brito, V.; Morata, L.; de Diego, I. C.; Sorli, L.; Iftimie, S.; Perez-Vidal, R.; Garcia-Pardo, G.; (2016). Effectiveness of sequential intravenous-to-oral antibiotic switch therapy in hospitalized patients with gram-positive infection: the SEQUENCE cohort study. European Journal Of Clinical Microbiology & Infectious Diseases, 35(8), 1269-1276. DOI: 10.1007/s10096-016-2661-5

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Article's DOI: 10.1007/s10096-016-2661-5

Entity: Universitat Rovira i Virgili

Journal publication year: 2016

Publication Type: Journal Publications