Optimizing Antibiotic Stewardship: Impact of Intravenous to Oral Conversion in General Medicine at a Tertiary Care Hospital

Antibiotics are used for the effective management of infectious diseases, a practice that is frequently misapplied nowadays. In order to monitor the conversion of IV to oral antibiotics, assess their rationality, and evaluate their effect on the length of hospital stays a prospective observational study was conducted. The study was divided into two phases; a baseline period of two months in which the antibiotics prescribed in the general medicine department were analysed. The intervention phase of four months consisted of the introduction of guidelines for IV to oral switch and conversion and analysis of IV to oral antibiotic conversion. The results revealed the majority of the participants were females and were from the age group 60 and above. A greater part of the study population had comorbidities, and the most common comorbidity was hypertension with type 2 diabetes mellitus. The conversion of IV to oral antibiotics was analysed for 159 patients and 79% of the antibiotics were converted and 21% were not. The most frequent type of conversion practice observed was switch therapy followed by step-down therapy and sequential therapy. The majority of the antibiotics were prescribed without a culture and sensitivity test. It was shown that the average length of hospital stay was 4.13 ± 1.5 days.