A. Vital signs should be good or improving |
Systolic blood pressure should be stable without inotropics or fluid resuscitation |
B. Signs and symptoms related to the infection have to be resolved or improved |
Temperature should be >36 °C OR <38.3°C a without antipyretics, |
C. The gastrointestinal tract (GIT) has to be intact and functioning |
Absence of the following conditions |
malabsorption syndrome, short bowel syndrome, severe gastroparesis, ileus, continuous nasogastric suction |
D. The oral route should not be compromised |
No vomiting |
Patient should be cooperative |
E. Absence of contraindicated infections |
Adequate antimicrobial concentrations are not achievable at the site of infection by oral administration |
Absence of the following infections |
(severe) sepsis |
fasciitis necroticans |
CNS infection |
S. aureus bacteraemia |
endovascular infection (e.g. endocarditis) |
F. An oral variant b of the antibiotic with good c bioavailability has to exist |
a Chosen by the experts.
b Oral variant can be another antibiotic with appropriate microbiological profile.
c 60%–90%, in accordance with the literature.
Bron: Akhloufi H, Hulscher M, Melles DC, Prins JM, van der Sijs H, Verbon A. Development of operationalized intravenous to oral antibiotic switch criteria. J Antimicrob Chemother. 2017;72:543-546.