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Trials 2020 May 27;21(1):431. Epub 2020 May 27.

Centre for Cancer Research and Cell Biology, Queen's University Belfast, Lisburn Road, Belfast, BT9 7AE, UK.

Background: Neutropenic sepsis remains a common treatment complication for patients receiving systemic anti-cancer treatment. The UK National Institute for Health and Care Excellence have not recommended switching from empirical intravenous antibiotics to oral antibiotics within 48 h for patients assessed as low risk for septic complications because of uncertainty about whether this would achieve comparable outcomes to using intravenous antibiotics for longer. The UK National Institute for Health Research funded the EASI-SWITCH trial to tackle this uncertainty. Read More

J Infect Chemother 2020 Apr 10. Epub 2020 Apr 10.

Advanced Informatics and Analytics, Astellas Pharma Inc., 2-5-1 Nihonbashi Honcho, Chuo-ku, Tokyo, 103-8411, Japan. Electronic address:

The Japanese Respiratory Society 2017 guidelines strongly recommend switching from intravenous (IV) to oral antibiotics in patients with community-acquired pneumonia (CAP), following improvement in clinical symptoms and laboratory findings. Here, we retrospectively investigated the real-world, nationwide treatment and switching patterns for hospitalized patients with CAP in Japan using administrative data from 372 Japanese Diagnosis Procedure Combination hospitals from April 2010 to December 2018. Hospitalizations for CAP (patient age ≥20 years) with an A-DROP classification for CAP severity and IV antibiotics initiated on the admission date were included. Read More

Travel Med Infect Dis 2020 Feb 24:101605. Epub 2020 Feb 24.

Pharmacy Services Division, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.

Background: The emergence of antimicrobial resistance of many bacteria is a significant drawback of antimicrobial use. A key measure to assess antimicrobial use is point prevalence study.

Methods: This was a point prevalence study of all hospitalized patients at Johns Hopkins Aramco Healthcare, a 350-bed hospital, and was conducted at two-points from January 2017 to January 2019. Read More

BMC Infect Dis 2020 Feb 3;20(1):102. Epub 2020 Feb 3.

Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.

Background: Minimising antimicrobial overuse is needed to limit antimicrobial resistance. There is little evidence on how often microbiological testing informs antimicrobial de-escalation (e.g. Read More

Swiss Med Wkly 2019 Oct 27;149:w20135. Epub 2019 Oct 27.

Division of Internal Medicine, University Hospital Basel, Switzerland / Department of Clinical Research, University of Basel, Switzerland.

Aims Of The Study: Inappropriate use of antimicrobials is associated with the emergence of antimicrobial resistance and adverse events. Antimicrobial stewardship programmes may both optimise treatment of infections and reduce antimicrobial resistance but are implemented in only a minority of Swiss hospitals. In addition, data on prescribing patterns and quality are scarce. Read More

Ir Med J 2019 09 12;112(8):987. Epub 2019 Sep 12.

Discipline of Bacteriology, School of Medicine, National University of Ireland, Galway

Aims To explore doctors’ perceptions of the motivators and barriers to complying with intravenous to oral switch antibiotic guidelines in a Model 4 Irish hospital. Methods A cross-sectional study was carried out amongst doctors attending hospital-wide educational sessions in November 2018 via a validated paper-based survey post ethical approval. Data were independently analysed using SPSS. Read More

Int J Environ Res Public Health 2019 09 23;16(19). Epub 2019 Sep 23.

Members of the Italian Paediatric Collaborative Osteomyelitis Study Group: Luisa Abbagnato (Como); Samantha Bosis (Milano); Grazia Bossi (Pavia); Fabio Cardinale (Bari); Elio Castagnola (Genova); Salvatore Cazzato (Ancona); Liviana Da Dalt (Padova); Sofia D’Elios (Pisa); Icilio Dodi (Parma): Daniele Donà (Padova); Susanna Esposito (Perugia); Susanna Falorni (Grosseto); Silvia Fasoli (Mantova); Enrico Felici (Alessandria); Romina Gallizzi (Messina); Silvia Garazzino (Torino); Maria Rita Govoni (Ferrara); Francesca Landi (Genova); Marcello Lanari (Bologna); Giuseppe Losurdo (Genova); Andrea Lo Vecchio (Napoli); Paola Marchisio (Milano); Flora Marino (Rovigo); Alberto Martelli (Garbagnate Milanese); Pasqua Massagli (Bari); Antonella Meini (Brescia); Alessandra Meneghel (Vicenza); Chiara Minotti (Padova); Gregorio Paolo Milani (Milano); Alma Nunzia Olivieri (Napoli); Luca Pierantoni (Bologna); Diego Peroni (Pisa); Roberta Ponti (Udine); Simone Rugolotto (Rovigo); Paola Serraino (Alessandria); Simone Sferrazza Papa (Chieti); Monica Sprocati (Ferrara); Camilla Totaro (Bologna); Gianluca Vergine (Rimini); Alberto Verrotti (L’Aquila).

: The European Society of Pediatric Infectious Diseases (ESPID) guidelines for acute hematogenous osteomyelitis (AHOM) have been published recently. In uncomplicated cases, an early (2-4 days) switch to oral empirical therapy, preferentially with flucloxacillin, is recommended in low methicillin-resistant settings. We conducted a survey with the aim of evaluating the behaviors of Italian pediatricians at this regard. Read More

Rev Esp Quimioter 2019 Sep;32 Suppl 2:42-46

Jose L del Pozo, Infectious Diseases Division and Clinical Microbiology. Clínica Universidad de Navarra, Spain.

Sepsis is the major cause of mortality from any infectious disease worldwide. The goals of antimicrobial stewardship are to achieve optimum clinical outcomes and to ensure cost effectiveness and minimum unintended consequences, including toxic effects, selection of pathogenic organisms, and resistance. The combination of inadequate diagnostic criteria for sepsis with the extraordinary time pressure to provide broad-spectrum antimicrobial therapy is troubling from a stewardship perspective. Read More

J Antimicrob Chemother 2019 11;74(11):3344-3351

Department of Internal Medicine, Division of Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Background: Staphylococcus aureus bacteraemia (SAB) is a serious and often fatal infectious disease. The quality of management of SAB is modifiable and can thus affect the outcome. Quality indicators (QIs) can be used to measure the quality of care of the various aspects of SAB management in hospitals, enabling professionals to identify targets for improvement and stimulating them to take action. Read More

Int J Antimicrob Agents 2020 Jan 27;55(1):105769. Epub 2019 Jul 27.

Department of Clinical Pharmacy, Meander Medical Center, Amersfoort, The Netherlands. Electronic address:

Objectives: To assess the effectiveness of a combined intervention on the timing and rate of switching from intravenous (IV) to oral antibiotic therapy.

Materials And Methods: The study used a historically-controlled prospective intervention design. Interventions consisted of educating physicians, handing out pocket-sized cards and providing switch advice in the electronic patient record (EPR). Read More

BMC Infect Dis 2019 Jul 22;19(1):650. Epub 2019 Jul 22.

School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.

Background: This study aimed to evaluate the oral switch (OS) stewardship intervention in the intensive care unit (ICU).

Methods: This was a retrospective study with a convenience sample in two Brazilian ICUs from different hospitals in patients with sepsis receiving antibiotic therapy. The stewardship intervention included OS in patients diagnosed with sepsis when clinical stability was achieved. Read More

Core Evid 2019 5;14:31-40. Epub 2019 Jul 5.

Department of Health Sciences, University of Genoa, Genoa, Italy.

Introduction: Tedizolid phosphate is an oxazolidinone approved for the treatment of acute bacterial skin and skin-structure infections (ABSSSIs) and active against methicillin-resistant .

Aims: The objective of this article was to review the evidence for the efficacy and safety of tedizolid phosphate for the treatment of ABSSSI.

Evidence Review: Approval of tedizolid phosphate for the treatment of ABSSSI was based on the results of two phase III randomized controlled trials, ESTABLISH-1 (NCT01170221) and ESTABLISH-2 (NCT01421511), comparing 6-day once-daily tedizolid vs 10-day twice-daily linezolid. Read More

BMJ Open 2019 07 9;9(7):e026688. Epub 2019 Jul 9.

Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.

Introduction: High morbidity and mortality rates of proven bacterial infection are the main reason for substantial use of intravenous antibiotics in neonates during the first week of life. In older children, intravenous-to-oral switch after 48 hours of intravenous therapy has been shown to have many advantages and is nowadays commonly practised. We, therefore, aim to evaluate the effectiveness, safety and cost-effectiveness of an early intravenous-to-oral switch in neonates with a probable bacterial infection. Read More

Clin Microbiol Infect 2020 Mar 23;26(3):299-306. Epub 2019 May 23.

Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, SC, USA.

Background: The role of oral antimicrobial agents in the management of bloodstream infections (BSI) is currently evolving.

Objectives: This narrative review summarizes and appraises clinical studies that examined transition from intravenous to oral antimicrobials or compared effectiveness of various oral agents for definitive therapy of uncomplicated and complicated BSI in adults.

Sources: Relevant English-language studies from MEDLINE (since inception) and presented abstracts at international scientific meetings (since 2017). Read More

Expert Opin Drug Saf 2019 08 13;18(8):635-650. Epub 2019 Jun 13.

b Department of Health Sciences, University of Genoa , Genoa , Italy.

Introduction: Acute bacterial skin and skin-structure infections (ABSSSI) may develop in both in-patients and out-patients, possibly with a severe clinical presentation. Since most phase 3 randomized clinical trials have shown non-inferiority in efficacy across different agents, considerations regarding their different safety profiles inevitably play a crucial role in the everyday choice about which of them should be employed for the treatment of ABSSSI.

Areas Covered: In this review, the authors discuss the safety profile of different treatment options for ABSSSI. Read More

Int J Mol Sci 2019 May 15;20(10). Epub 2019 May 15.

Department of Pharmacy, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.

Single nucleotide polymorphisms in drug-metabolizing genes may affect tacrolimus pharmacokinetics. Here, we investigated the influence of genotypes of , , and on the concentration/dose (C/D) ratio of tacrolimus and episodes of acute graft-versus-host disease (GVHD) in Japanese recipients of allogeneic hematopoietic stem cell transplantation (HSCT). Thirty-six patients receiving the first HSCT using tacrolimus-based GVHD prophylaxis were enrolled with written informed consent. Read More

Braz J Infect Dis 2019 Mar - Apr;23(2):86-94. Epub 2019 May 9.

Pfizer Inc, Groton, CT, USA.

Background: Early antibiotic switch and early discharge protocols have not been widely studied in Latin America. Our objective was to describe real-world treatment patterns, resource use, and estimate opportunities for early switch from intravenous to oral antibiotics and early discharge for patients hospitalized with methicillin-resistant Staphylococcus aureus complicated skin and soft-tissue infections.

Materials/methods: This retrospective medical chart review recruited 72 physicians from Brazil to collect data from patients hospitalized with documented methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections between May 2013 and May 2015, and discharged alive by June 2015. Read More

Ther Adv Infect Dis 2019 Jan-Dec;6:2049936118823655. Epub 2019 Feb 4.

Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, UK.

Purpose: The objective of this prospective, observational study was to describe the treatment, severity assessment and healthcare resources required for management of patients with acute bacterial skin and skin structure infections who were unsuitable for beta-lactam antibiotic treatments.

Methods: Patients were enrolled across five secondary care National Health Service hospitals. Eligible patients had a diagnosis of acute bacterial skin and skin structure infection and were considered unsuitable for beta-lactam antibiotics (e. Read More

PLoS One 2018 29;13(11):e0207413. Epub 2018 Nov 29.

Division of Infectious Diseases, Shizuoka Cancer Center Hospital, Sunto-gun, Shizuoka, Japan.

The most common complication in cancer patients is catheter-related bloodstream infection (CRBSI), of which Staphylococcus aureus is a common pathogen. Although S. aureus CRBSI patients are recommended for prolonged intravenous therapy, this is often not feasible. Read More

Ann Pharm Fr 2019 Jan 6;77(1):38-45. Epub 2018 Oct 6.

Service pharmaceutique, hospices Civils de Lyon, hôpital de la Croix-Rousse, groupement hospitalier Nord, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France. Electronic address:

Introduction: Potassium is used to treat or prevent hypokalemia and exhibits all the characteristics of an intravenous to oral therapy conversion program. Despite this, the intravenous route for potassium replacement seems frequently unjustified.

Objectives: To determine the impact of a conversion program on the use of intravenous and oral galenic forms in a university tertiary care hospital. Read More

Eur J Drug Metab Pharmacokinet 2019 Apr;44(2):139-157

Faculty of Medical Sciences, University of Kragujevac, Zmaj Jovina Street, 30, Kragujevac, 34000, Serbia.

Second-generation triazoles were developed in response to the quest for more efficacious and safer therapeutic options for the treatment of severe systemic aspergillosis and candidiasis. These agents include voriconazole, posaconazole, isavuconazole, and ravuconazole. The aim of this review was to present and compare the pharmacokinetic characteristics of second-generation triazoles for the treatment of invasive aspergillosis and candidiasis, emphasizing their clinical implications. Read More

N Engl J Med 2019 01 28;380(5):415-424. Epub 2018 Aug 28.

From the Department of Cardiology, Herlev-Gentofte University Hospital (K.I., M.S., C.F.K.), Department of Cardiology, the Heart Center, Rigshospitalet, Copenhagen University Hospital (N.I., D.E.H., E.L.F., L.K., H.B.), the Departments of Infectious Diseases (J.H.-L.) and Clinical Microbiology (C.M.), Rigshospitalet, the Department of Cardiology, Hillerød Hospital (N.T.), and the Department of Clinical Microbiology, Slagelse Hospital and Institute of Clinical Medicine (J.J.C.), University of Copenhagen, Copenhagen, the Departments of Cardiology (S.U.G.) and Clinical Microbiology (F.R.), Odense University Hospital, Odense, the Departments of Cardiology (T.M.) and Cardiology and Epidemiology and Biostatistics (C.T.-P.), Aalborg University Hospital, the Department of Clinical Microbiology, Aalborg University Hospital, Aalborg University (H.C.S.), and the Department of Health Science and Technology, Aalborg University (C.T.-P.), Aalborg, the Department of Cardiology, Zealand University Hospital, Roskilde (H.E.), the Department of Cardiology, Aarhus University Hospital, Aarhus (K.T.J.), the Department of Cardiology, University Hospital of Copenhagen, Gentofte (N.E.B.), and the Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen (K.F.) - all in Denmark.

Background: Patients with infective endocarditis on the left side of the heart are typically treated with intravenous antibiotic agents for up to 6 weeks. Whether a shift from intravenous to oral antibiotics once the patient is in stable condition would result in efficacy and safety similar to those with continued intravenous treatment is unknown.

Methods: In a randomized, noninferiority, multicenter trial, we assigned 400 adults in stable condition who had endocarditis on the left side of the heart caused by streptococcus, Enterococcus faecalis, Staphylococcus aureus, or coagulase-negative staphylococci and who were being treated with intravenous antibiotics to continue intravenous treatment (199 patients) or to switch to oral antibiotic treatment (201 patients). Read More

J Antimicrob Chemother 2018 08;73(8):2201-2206

Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, CA Rotterdam, The Netherlands.

Objectives: To evaluate a clinical decision support system (CDSS) based on consensus-based intravenous to oral switch criteria, which identifies intravenous to oral switch candidates.

Methods: A three-step evaluation study of a stand-alone CDSS with electronic health record interoperability was performed at the Erasmus University Medical Centre in the Netherlands. During the first step, we performed a technical validation. Read More

Curr Opin Infect Dis 2018 04;31(2):163-169

Azienda Sanitaria Universitaria Integrata, Presidio Ospedaliero Universitario Santa Maria della Misericordia.

Purpose Of Review: Skin and soft tissue infections prevalence is increasing and represent a frequent cause of hospital admission. New guidelines have become available in order to better define these infections and their response to antimicrobial treatment. Gram-positive bacteria, in particular Staphylococcus aureus, remain the most frequently isolated pathogens in skin and soft tissue infections. Read More

Int J Antimicrob Agents 2018 May 5;51(5):794-798. Epub 2018 Jan 5.

Université de Lorraine, CHRU-Nancy, Infectious Diseases Department, F-54000 Nancy, France; Université de Lorraine, APEMAC, F-54000 Nancy, France. Electronic address:

Bloodstream infections (BSIs) are common, however international guidelines are available only for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and candidaemia. This international ESCMID cross-sectional survey, open from December 2016 to February 2017, explored the management of BSIs by infection specialists. All infection specialists (senior or trainees) giving at least weekly advice on positive blood cultures could participate. Read More

J Eval Clin Pract 2018 04 28;24(2):454-455. Epub 2017 Nov 28.

School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.

J Infect Chemother 2018 Jan 16;24(1):40-44. Epub 2017 Nov 16.

Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, Japan.

An early switch from intravenous to oral antimicrobial therapy is useful for reducing the duration of the hospitalization in adult patients with community acquired-pneumonia, whereas the efficacy of switch therapy for pediatric patients with community acquired (CA)-lower respiratory tract infection (LRTI) is uncertain. The aim of this study is to investigate the efficacy of switch therapy for LRTI in patients with severe motor intellectual disabilities (SMID). This retrospective study was performed on 92 patients with SMID who were admitted to the Department of Pediatrics at the Hospital of University of Occupational and Environmental Health, Japan from April 1, 2010 to March 31, 2017 for the suspicion of bacterial LRTI and were initially treated with an intravenous antimicrobial agent. Read More

Antimicrob Resist Infect Control 2017 15;6:81. Epub 2017 Aug 15.

Department of Internal Medicine, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands.

Background: Timely switch from intravenous (iv) antibiotics to oral therapy is a key component of antimicrobial stewardship programs in order to improve patient safety, promote early discharge and reduce costs. We have introduced a time-efficient and easily implementable intervention that relies on a computerized trigger tool, which identifies patients who are candidates for an iv to oral antibiotic switch.

Methods: The intervention was introduced on all internal medicine wards in a teaching hospital. Read More

Future Microbiol 2017 08 7;12:847-851. Epub 2017 Jul 7.

Zydus Research Center, Cadila Health Care Ltd, Sarkhej-Bavla NH No 8A, Moraiya, Ahmedabad 382 210, Gujarat, India.

J Paediatr Child Health 2017 07;53(7):722

Children's Hospital at Westmead, Sydney.

J Med Chem 2017 05 24;60(9):3755-3775. Epub 2017 Apr 24.

Actelion Pharmaceuticals Ltd. , Gewerbestrasse 16, CH-4123 Allschwil, Switzerland.

Our strategy to combat resistant bacteria consisted of targeting the GyrB/ParE ATP-binding sites located on bacterial DNA gyrase and topoisomerase IV and not utilized by marketed antibiotics. Screening around the minimal ethyl urea binding motif led to the identification of isoquinoline ethyl urea 13 as a promising starting point for fragment evolution. The optimization was guided by structure-based design and focused on antibacterial activity in vitro and in vivo, culminating in the discovery of unprecedented substituents able to interact with conserved residues within the ATP-binding site. Read More

J Eval Clin Pract 2017 Aug 7;23(4):848-852. Epub 2017 Mar 7.

Department of Pharmacy, Groupe Hospitalier Paris Saint-Joseph, Paris, France.

Rationale, Aims, And Objectives: Intravenous (IV) to oral (PO) drug switch is a challenge for tertiary care institutions for several reasons: catheter-related infections, patient's pain and discomfort or higher costs, and overuse of IV drugs considered as an irrational use of medicines. The objective was to evaluate yearly acetaminophen and proton-pump inhibiters' (PPIs) IV/PO ratios from 2011 to 2015 and to determine their correlation with all drugs IV/PO ratios and their relevance as drug tracers. A secondary objective was to estimate costs savings associated with a IV to PO switch improvement. Read More

Enferm Infecc Microbiol Clin 2017 Jan;35 Suppl 1:41-45

Servicio de Farmacia, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address:

The economic cost of treating an infection can be influenced by multiple factors related to patient characteristics, the type of infection, the isolated microorganism and some mechanisms of bacterial resistance. Of these, the factor generating the largest number of studies is bacterial resistance but many of these studies show major limitations. Antimicrobial stewardship has been proposed as a means to reduce the economic cost of treating infections. Read More

J Antimicrob Chemother 2017 02 20;72(2):543-546. Epub 2016 Dec 20.

Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.

Objectives: Despite huge overlap in suggested criteria for a safe intravenous (iv)-to-oral antibiotic switch, there is considerable variation in their operationalization. The objective of this study was to develop a set of measurable conditions that should be met in adult hospitalized patients for a safe iv-to-oral switch.

Methods: A RAND-modified Delphi procedure was performed to develop a set of operationalized iv-to-oral switch criteria. Read More

Int J Hematol 2017 Mar 7;105(3):361-368. Epub 2016 Nov 7.

Department of Pharmacy, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

The aim of this retrospective study was to identify variable factors affecting tacrolimus blood concentration during the switch from continuous intravenous infusion to twice-daily oral administration in allogeneic hematopoietic stem cell transplant recipients (n = 73). The blood concentration/dose ratio of tacrolimus immediately before the change from continuous infusion (C/Div) was compared with that between 3 and 5 days after the change to oral administration (C/Dpo). Median (C/Dpo)/(C/Div) was 0. Read More

Int J Antimicrob Agents 2016 Nov 20;48(5):498-503. Epub 2016 Aug 20.

Department of Medicine, Division of Infectious Diseases, University of South Carolina School of Medicine, Columbia, SC, USA. Electronic address:

There is paucity of data evaluating intravenous-to-oral antibiotic switch options for Gram-negative bloodstream infections (BSIs). This retrospective cohort study examined the effectiveness of oral antibiotics for definitive treatment of Gram-negative BSI. Patients with Gram-negative BSI hospitalised for <14 days at Palmetto Health Hospitals in Columbia, SC, from 1 January 2010 through 31 December 2013 and discharged on oral antibiotics were included in this study. Read More

Ann Am Thorac Soc 2017 Feb;14(2):200-205

2 Division of Infectious Diseases, Intermountain Healthcare, Murray, Utah.

Rationale: Guidelines recommend a switch from intravenous to oral antibiotics once patients who are hospitalized with pneumonia achieve clinical stability. However, little evidence guides the selection of an oral antibiotic for patients with health care-associated pneumonia, especially where no microbiological diagnosis is made.

Objectives: To compare outcomes between patients who were transitioned to broad- versus narrow-spectrum oral antibiotics after initially receiving broad-spectrum intravenous antibiotic coverage. Read More

World J Clin Pediatr 2016 Aug 8;5(3):244-50. Epub 2016 Aug 8.

Nathan Batchelder, Tsz-Yin So, Department of Pharmacy, Moses H. Cone Memorial Hospital, Greensboro, NC 27401, United States.

Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention. If left untreated, acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis. Early treatment is necessary to prevent complications, and the standard of care is progressing to a shorter duration of intravenous (IV) antibiotics and transitioning to oral therapy for the rest of the treatment course. Read More

PLoS One 2016 17;11(8):e0160551. Epub 2016 Aug 17.

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Background: To promote appropriate antimicrobial use in bloodstream infections (BSIs), we initiated an intervention program consisting of electronic alerts and automated infectious diseases consultations in which the identification and antimicrobial susceptibility test (ID/AST) results were reported.

Methods: We compared the appropriateness of antimicrobial prescriptions and clinical outcomes in BSIs before and after initiation of the program. Appropriateness was assessed in terms of effective therapy, optimal therapy, de-escalation therapy, and intravenous to oral switch therapy. Read More

Pharmazie 2016 Jun;71(6):320-6

Paclitaxel (PTX), a BCS class IV drug that is characterized by its poor solubility and is a substrate for P-glycoprotein, is one of the most widely used antineoplastic agents. However, oral administration of PTX for chemotherapy is highly challenging. The aim of this study was to develop bile-salt liposomes (BS-Lips) to enhance the absorption of PTX and thus improve its therapeutic outcome. Read More

Clin Infect Dis 2016 10 22;63(8):1007-1016. Epub 2016 Jul 22.

Cempra Inc, Chapel Hill, North Carolina.

Background: Solithromycin, a novel macrolide antibiotic with both intravenous and oral formulations dosed once daily, has completed 2 global phase 3 trials for treatment of community-acquired bacterial pneumonia.

Methods: A total of 863 adults with community-acquired bacterial pneumonia (Pneumonia Outcomes Research Team [PORT] class II-IV) were randomized 1:1 to receive either intravenous-to-oral solithromycin or moxifloxacin for 7 once-daily doses. All patients received 400 mg intravenously on day 1 and were permitted to switch to oral dosing when clinically indicated. Read More

Lancet Infect Dis 2016 08 16;16(8):e139-52. Epub 2016 Jun 16.

Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia. Electronic address:

Few studies are available to inform duration of intravenous antibiotics for children and when it is safe and appropriate to switch to oral antibiotics. We have systematically reviewed antibiotic duration and timing of intravenous to oral switch for 36 paediatric infectious diseases and developed evidence-graded recommendations on the basis of the review, guidelines, and expert consensus. We searched databases and obtained information from references identified and relevant guidelines. Read More

Rev Chilena Infectol 2016 Apr;33(2):177-86

Community acquired pneumonia (CAP) is an important cause of morbidity and mortality around the world, with high treatment costs due to hospitalization and complications (adverse events due to medications, antibiotic resistance, healthcare associated infections, etc.). It has been proposed administration of short courses and early switch of intravenous administration to oral therapy to avoid costs and complications. Read More

Eur J Clin Microbiol Infect Dis 2016 Aug 14;35(8):1269-76. Epub 2016 May 14.

Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.

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. Read More

J Antimicrob Chemother 2016 08 27;71(8):2295-9. Epub 2016 Apr 27.

School of Social Sciences, The University of New South Wales, Sydney, NSW 2052, Australia

Objectives: Escalating antimicrobial resistance worldwide necessitates urgent optimization of antimicrobial prescribing to preserve antibiotics for future generations. Early intravenous (iv) to oral switch campaigns are one strategy that hospital-based antimicrobial stewardship programmes can incorporate to minimize inappropriate antibiotic use. Yet, iv antibiotics continue to be offered for longer than is clinically indicated, increasing hospital length of stay, increasing costs and placing patients at risk (e. Read More

Lancet Infect Dis 2016 Jul 3;16(7):847-856. Epub 2016 Mar 3.

Department of Internal Medicine, Division of Infectious Diseases, Centre for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, Amsterdam, Netherlands. Electronic address:

Background: Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes: clinical outcomes, adverse events, costs, and bacterial resistance rates.

Methods: We identified 14 stewardship objectives and did a separate systematic search for articles relating to each one in Embase, Ovid MEDLINE, and PubMed. Read More

Artif Intell Med 2016 Mar 22;68:29-36. Epub 2016 Feb 22.

Department of Microbiology and Infectious Diseases, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, Québec, Canada J1H 5N4. Electronic address:

Objective: Antimicrobial stewardship programs have been shown to limit the inappropriate use of antimicrobials. Hospitals are increasingly relying on clinical decision support systems to assist in the demanding prescription reviewing process. In previous work, we have reported on an emerging clinical decision support system for antimicrobial stewardship that can learn new rules supervised by user feedback. Read More

Trials 2015 Oct 9;16:450. Epub 2015 Oct 9.

Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Goldenfelsstr. 19-21, D-50935, Köln, Germany.

Background: Current guidelines recommend that patients with Staphylococcus aureus bloodstream infection (SAB) are treated with long courses of intravenous antimicrobial therapy. This serves to avoid SAB-related complications such as relapses, local extension and distant metastatic foci. However, in certain clinical scenarios, the incidence of SAB-related complications is low. Read More

Infect Dis Ther 2015 Sep 11;4(Suppl 1):15-25. Epub 2015 Sep 11.

Department of Pharmacy, Singapore General Hospital, Singapore, Singapore.

Introduction: Acute bacterial skin and skin structure infections (ABSSSIs) are among the most common infections treated in hospitals, but to date, there has been little information with regards to the implementation of Antimicrobial Stewardship Programs (ASPs) for patients with ABSSSIs. Hence, we aim to evaluate the impact of ASPs on the following outcomes in patients with ABSSSIs: duration of therapy and hospital stay, 14-day reinfection, infection-related readmissions and mortality.

Methods: A retrospective review of the ASP database was conducted, focusing on selected outcomes (as above) among all patients in whom the institution's ASP recommended a change in antibiotic regimen-de-escalation of the antibiotic based on culture results; discontinuation of the antibiotic; narrowing of the empirical coverage; and intravenous-to-oral (i. Read More

Respir Investig 2015 Sep 4;53(5):225-31. Epub 2015 Aug 4.

Division of Pulmonary Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo City, Tokyo 104-8560, Japan. Electronic address:

Background: Previous reports have documented the efficacy of an early switch from intravenous to oral antimicrobials in community-acquired pneumonia, but not aspiration pneumonia. Therefore, we assessed the feasibility and efficacy of these newly developed criteria for community-acquired pneumonia in patients with aspiration pneumonia.

Methods: This prospective observational study included consecutive patients admitted with aspiration pneumonia over a 10-month period at St. Read More