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Effectiveness of sequential intravenous-to-oral antibiotic switch therapy in hospitalized patients with gram-positive infection: the SEQUENCE cohort study.

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dc.contributor.author Rodriguez-Pardo, D.
dc.contributor.author Pigrau, C.
dc.contributor.author Campany, D.
dc.contributor.author Diaz-Brito, V.
dc.contributor.author Morata, L.
dc.contributor.author Diego, I. C. de
dc.contributor.author Sorli Redó, M. Luisa
dc.contributor.author Iftimie, Simona Mihaela
dc.contributor.author Pérez-Vidal, R.
dc.contributor.author García-Pardo, G.
dc.contributor.author Larrainzar-Coghen, T.
dc.contributor.author Almirante, Benito
dc.date.accessioned 2016-09-28T10:32:02Z
dc.date.available 2016-09-28T10:32:02Z
dc.date.issued 2016
dc.identifier.citation Rodriguez-Pardo D, Pigrau C, Campany D, Diaz-Brito V, Morata L, de Diego IC. et al. Effectiveness of sequential intravenous-to-oral antibiotic switch therapy in hospitalized patients with gram-positive infection: the SEQUENCE cohort study. Eur J Clin Microbiol Infect Dis. 2016 Aug;35(8):1269-76. doi: 10.1007/s10096-016-2661-5
dc.identifier.issn 0934-9723
dc.identifier.uri http://hdl.handle.net/10230/27318
dc.description.abstract Switching from intravenous to oral antibiotic therapy may improve inpatient management and reduce hospital stays and the complications of intravenous treatment. We aimed to assess the effectiveness of intravenous-to-oral antibiotic switch therapy and an early discharge algorithm in hospitalized patients with gram-positive infection. We performed a prospective cohort study with a retrospective comparison cohort, recruited from eight tertiary, acute-care Spanish referral hospitals. All patients included had culture-confirmed methicillin-resistant gram-positive infection, or methicillin-susceptible gram-positive infection and beta-lactam allergy and had received intravenous treatment with glycopeptides, lipopeptides, or linezolid. The study comprised two cohorts: the prospective cohort to assess the effectiveness of a sequential intravenous-to-oral antibiotic switch algorithm and early discharge, and a retrospective cohort in which the algorithm had not been applied, used as the comparator. A total of 247 evaluable patients were included; 115 in the prospective and 132 in the retrospective cohort. Forty-five retrospective patients (34 %) were not changed to oral antibiotics, and 87 (66 %) were changed to oral antibiotics without following the proposed algorithm. The duration of hospitalization was significantly shorter in the prospective cohort compared to the retrospective group that did not switch to oral drugs (16.7 ± 18.7 vs 23 ± 13.4 days, P  < 0.001). No differences were observed regarding the incidence of catheter-related bacteraemia (4.4 % vs 2.6 %, P = 0.621). Our results suggest that an intravenous-to-oral antibiotic switch strategy is effective for reducing the length of hospital stay in selected hospitalized patients with gram-positive infection.
dc.description.sponsorship This study was supported by an unrestricted educational grant from Pfizer S.L.U and by the Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III, co-financed by the European Development Regional Fund “A way to achieve Europe” and the Spanish Network for Research in Infectious Diseases (REIPI RD12/0015). Drs D. Rodrıguez-Pardo, C. Pigrau, L. Sorli, and B. Almirante belong to the REIPI network.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartof European Journal of Clinical Microbiology & Infectious Diseases. 2016 Aug;35(8):1269-76
dc.rights © The Author(s) 2016/nOpen Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.other Infeccions -- Tractament
dc.subject.other Antibiòtics
dc.title Effectiveness of sequential intravenous-to-oral antibiotic switch therapy in hospitalized patients with gram-positive infection: the SEQUENCE cohort study.
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1007/s10096-016-2661-5
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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