Outcomes of a Prospective Surveillance and a Local Consensus-based Guideline to Promote the Intravenous-oral Conversion of AntibioticsR. Muenpa, O. Waleekhachonloet,* C. Limwattananon, J. Johns, S. Limwattananon, J. Schommer, L. Brown and S. Sakolchai
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An intravenous-to-oral antibiotic conversion can lower drug costs, reduce patient’s hospital stay, and improve patient’s comfort, without sacrificing effectiveness of the treatment. In Thailand, the IV-oral conversion has not received much attention from administrators as an effective cost containment strategy nor has been widely implemented. To examine the effects of an IV-oral conversion of antibiotics using two distinct approaches: the prospective surveillance and the local consensus-based guideline. A pre-post study design was used, and effects of each strategy were examined twice (i.e., the immediate effects and the effects at month four). Measures of the effectiveness included incidence of converted prescriptions when they met the conversion criteria, excess IV days of target drugs, and potentially avoidable cost (PAC). The prospective surveillance increased the conversion incidence by 14%, reduced the excess IV days by 72% and PAC by 71% for the immediate assessment, and had no effects at month four. The local consensus-based guideline increased the conversion incidence by 7% as the immediate effect, and reduced the excess days by 44% and 52% as the immediate and four-month effects, respectively. This was accompanied by a reduction in the PAC by 55% for the four-month assessment. Both prospective surveillance and local consensus-based guideline strategies to promote IV-oral conversion of antibiotics for hospitalized patients provided positive economic impacts. The local consensus-based guideline yielded greater long-term benefits. The prospective surveillance yielded a greater effect but for a shorter period, thus should be implemented on a continual basis.
Keyword:
clinical pharmacist, guideline, interventions, IV-oral conversion, Prospective Surveillance, Consensus-based, Antibiotic
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