Highlights
- •This systematic review summarized the evidence available on ASPs to improve IV-to-PO antimicrobial switch therapy.
- •All interventions on IV-to-PO antimicrobial switch reported in the literature were listed and described.
- •The study demonstrated that all the interventions shown to be effective and safe.
- •Interventions on IV-to-PO antimicrobial switch were associated with a significant reduction in costs.
Abstract
Background
This review aimed to summarize the available evidence on the effectiveness and safety
of antimicrobial stewardship interventions to improve the practice of IV-to-PO antimicrobial
switch therapy in hospitalized adults.
Methods
Following the PRISMA guidelines, we searched Cochrane Central Register of Controlled
Trials (CENTRAL), MEDLINE/PubMed, and Scopus from inception to September 1, 2020,
for original articles investigating any interventions aimed to improve the practice
of IV-to-PO antimicrobial switch therapy in hospitalized adults with infectious diseases.
We included randomized controlled trials (RCTs) and quasi-experimental studies. Studies
were excluded if they evaluated drugs other than antimicrobials, head-to-head comparison
of interventions, included pediatrics or oncology patients.
Results
Of 506 unique citations identified, 36 studies met the inclusion criteria. The 36
included studies reported 92 interventions as a single (n = 10) or a bundle of interventions
(n = 26). The most common interventions used were guideline/protocol/pathway (n = 25),
audit and feedback (n = 20), and education (n = 17).
Conclusions
This review provides health care providers with a comprehensive summary on the interventions
to promote IV-to-PO antimicrobial switch. While no one intervention could be identified
as the safest and most effective as most of the included studies used a bundle of
interventions, all interventions resulted in optimizing antibiotic use and reducing
health care expenditures without compromising the clinical outcomes. As such, each
hospital should design and utilize interventions that are applicable based on available
resources and expertise.
Key Words
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Article Info
Publication History
Published online: May 26, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
