Conversion of intravenous to oral antibiotic therapy in an adult intensive care unit

Abstract

Objective: To identify the possibility of alteration of intravenous (IV) to oral (PO) therapy for ampicillin/sulbactam and cefuroxime in adult patients treated in intensive care units (ICUs), and to describe the profile and consumption of antimicrobials prescribed for these patients. Methods: A descriptive, cross-sectional, and retrospective documentary study based on the analysis of electronic prescriptions and data from the electronic medical record of patients admitted to adult intensive care units in two hospitals, from July to August 2019. The consumption of antimicrobials was measured using the Anatomical Therapeutic Chemical/Daily Defined Dose (ATC/DDD) methodology per 100 beds-day. Results: Of the patients admitted to the study units, 23 (5.5%) received ampicillin/sulbactam or cefuroxime; the time of the ampicillin/sulbactam treatment was 7.25 (±2.07) days and, with cefuroxime, 8 (±1.73) days; 3 (13%) of the patients followed were eligible to switch therapy or sequential therapy, there was no physician acceptance of the conversion recommendation. The highest consumption was observed in the penicillins therapeutic group (112.5 DDD/100 beds-day) and meropenem drug (68.8 DDD/100 beds-day). Conclusions: Antimicrobial use is high in ICUs, which can be related to the clinical complexity and to the microbiological profile of the patients. The practice of converting IV antibiotic therapy to PO in critically ill patients was not present in this study; however, its use can contribute to patient safety.