Guidelines
Switch Therapy

Switch Therapy

Notes

Oral antimicrobial has rapid absorption and high oral bioavailability systemically, that is comparable to IV administration route.

Antimicrobials with excellent oral bioavailability should be given PO as long as the patient is stable, has a functioning gastrointestinal tract and there are no drug or food interactions with the enteral form.

Patient with exclusions referenced on the previous screen, should NOT receive oral anitmicrobials.

Appropriate for Switch Therapy

Bioavailability: 37% - Azithromycin rapidly moves into tissues resulting in low serum concentrations, but high and persistent tissue concentrations, which makes it suitable for an IV to PO conversion.

IV Dose PO Dose
250 mg q24h 250 mg q24h
500 mg q24h 500 mg q24h

Note: Do not administer via jejunostomy tube (J-tube) as it bypasses the main site of absorption. Do not use ciprofloxacin with any tube as it may clog them.

Bioavailability: 70-89%

IV Dose PO Dose
400 mg q12h 500 mg q12h
400mg q8h 750mg q12h

Bioavailability: 90%

IV Dose PO Dose
600-900 mg q8h 300-450 mg q6h-q8h

Bioavailability: Greater than 90%

IV Dose PO Dose
100 mg q12h 100 mg q12h

Bioavailability: Greater than 90%

IV Dose PO Dose
100mg q24h 100mg q24h
150mg q24h 150mg q24h
200 mg q24h 200 mg q24h
400 mg q24h 400 mg q24h
800 mg q24h 800 mg q24h

Bioavailability: 100%

IV Dose PO Dose
600 mg q12h 600 mg q12h

Bioavailability: 100%

IV Dose PO Dose
500 mg q8h 500 mg q8h
500 mg q12h 500 mg q12h

Bioavailability: 90%

IV Dose PO Dose
400 mg q24h 400 mg q24h

Note Dose variable based on indication

Bioavailability: 90-100%

IV Dose 10 mL q6h of TRIMETHOPRIM 160 mg/mL and SUFAMETHOXAZOLE 800 mg/mL injection

PO Dose 1 DS q12h

Bioavailability: 96%

IV Dose PO Dose
200 mg (4mg/kg) q12h 200 mg q12h