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iv/orale switch

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  OR <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 

  No vomiting  

  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 

  (severe) sepsis 

  fasciitis necroticans 

  CNS infection 

  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.