Wanneer switchen naar oraal?
|A. Vital signs should be good or improving|
|Systolic blood pressure should be stable without inotropics or fluid resuscitation|
|B. Signs and symptoms related to the infection have to be resolved or improved|
|Temperature should be >36 °C AND <38.3°C (a) without antipyretics,|
|C. The gastrointestinal tract (GIT) has to be intact and functioning|
|Absence of the following conditions|
|malabsorption syndrome, short bowel syndrome, severe gastroparesis, ileus, continuous nasogastric suction|
|D. The oral route should not be compromised|
|Patient should be cooperative|
|E. Absence of contraindicated infections|
|Adequate antimicrobial concentrations are not achievable at the site of infection by oral administration|
|Absence of the following infections|
|S. aureus bacteraemia|
|endovascular infection (e.g. endocarditis)|
|F. An oral variant (b) of the antibiotic with good (c) bioavailability has to exist|
a Chosen by the experts.
b Oral variant can be another antibiotic with appropriate microbiological profile.
c 60%–90%, in accordance with the literature.
Bron: Akhloufi H, Hulscher M, Melles DC, Prins JM, van der Sijs H, Verbon A. Development of operationalized intravenous to oral antibiotic switch criteria. J Antimicrob Chemother. 2017;72:543-546.