IV to PO Conversion

Key Messages

Switching from intravenous (IV) to oral (PO) administration of antimicrobials can help increase patient mobility and reduces the chance of secondary peripheral IV line complications such as thrombophlebitis and catheter-related bloodstream infections.

With appropriate IV to PO conversion, there is no difference in treatment success or mortality.

Assess for IV to PO switch using established criteria.

Clinical pharmacists will review and change route of antimicrobial administration using established criteria.

IV to PO switch should be considered if:

1) Patient has received at least 48 hours of antimicrobial treatment.

2) Patient is able to tolerate oral medications AND has no factors impairing oral absorption

3) Patient is hemodynamically stable and demonstrating signs of clinical improvement.

Patients who may not be eligible for IV to PO switch:

Patient Factors

Hemodynamic instability
Active GI bleed
Disease states associated with malabsorption (e.g. active IBD, short gut syndrome, continuous enteral feeds that impair absorption of oral fluoroquinolones)

Clinical Syndromes

Infective Endocarditis
Bacterial Meningitis
Staphylococcus aureus bacteremia