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    BMC Infect Dis. 2006 Jun 8;6:94.

    A new approach to treatment of resistant gram-positive infections: potential impact of targeted IV to oral switch on length of stay.

    Desai M, Franklin BD, Holmes AH, Trust S, Richards M, Jacklin A, Bamford KB.

    Department of Infectious Diseases and Microbiology, Imperial College, London, UK. mdesai@hhnt.nhs.uk

    BACKGROUND: Patients prescribed intravenous (IV) glycopeptides usually remain in hospital until completion of this treatment. Some of these patients could be discharged earlier if a switch to an oral antibiotic was made. This study was designed to identify the percentage of inpatients currently prescribed IV glycopeptides who could be discharged earlier if a switch to an oral agent was used, and to estimate the number of bed days that could be saved. We also aimed to identify the patient group(s) most likely to benefit, and to estimate the number of days of IV therapy that could be prevented in patients who remained in hospital. METHODS: Patients were included if they were prescribed an IV glycopeptide for 5 days or more. Predetermined IV to oral antibiotic switch criteria and discharge criteria were applied. A multiple logistic regression model was used to identify the characteristics of the patients most likely to be suitable for earlier discharge. RESULTS: Of 211 patients, 62 (29%) could have had a reduced length of stay if they were treated with a suitable oral antibiotic. This would have saved a total of 649 inpatient days (median 5 per patient; range 1-54). A further 31 patients (15%) could have switched to oral therapy as an inpatient thus avoiding IV line use. The patients most likely to be suitable for early discharge were those with skin and soft tissue infection, under the cardiology, cardiothoracic surgery, orthopaedics, general medical, plastic surgery and vascular specialities, with no high risk comorbidity and less than five other regularly prescribed drugs. CONCLUSION: The need for glycopeptide therapy has a significant impact on length of stay. Effective targeting of oral antimicrobials could reduce the need for IV access, allow outpatient treatment and thus reduce the length of stay in patients with infections caused by antibiotic resistant gram-positive bacteria.

    PMID: 16762061 [PubMed - indexed for MEDLINE]

    PMCID: PMC1513579

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    Patient drug information

    • Vancomycin (Vancocin®)

      Vancomycin is used to treat colitis (inflammation of the intestine caused by certain bacteria) that may occur after antibiotic treatment. Vancomycin is in a class of medications called glycopeptide antibiotics. It works ...

    • Vancomycin Hydrochloride Injection (Vancocin®)

      Your doctor has ordered vancomycin, an antibiotic, to help treat your infection. The drug will be added to an intravenous fluid that will drip through a needle or catheter placed in your vein for 60 or more minutes, two ...