Change from intravenous to oral antibiotics is possible, even in cases of endocarditis or bone and joint infections
A study from Denmark by Iversen and colleagues that included 400 patients with left side endocarditis compared two groups. Their sample was composed by randomized patients who used the usual regimen of intravenous antibiotics for longer periods versus those who changed intravenous antibiotics to oral antibiotics after 10 days.(1) There was no inferiority and curiously side effects of the antibiotics were the same in both groups.
Ho-Kwong and his team studied a larger group including 1,554 patients who were also randomized into two groups. One group with the usual long-term intravenous antibiotic regimen and the other group who changed to oral antibiotics after 7 days.(2) Again, no inferiority was observed.
There is a clear trend toward less time of antibiotics use in several conditions, and less time of intravenous antibiotics even in conditions where there are evidence, based on studies, suggesting longer periods of treatment. Shorter hospitalization and reduced cost can be extremely useful to all, including health care systems and patients.
1. Iversen K, Ihleman N, Gill SU, Madsen T, Elming H, Jensen KT, et al.
N Engl J Med. 2019;380(5):415-24. https://doi.org/10.1056/NEJMoa1808312.
2. Li HK, Rombach I, Zambellas R, Walker S, McNally MA, Atkins BL, et al.
N Engl J Med. 2019;380(5):425-36. https://doi.org/10.1056/NEJMoa171092.