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Conclusions

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Conclusions

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  1. Feasibility Testing of an Indicator for Intravenous to Oral Switch with Highly Bio-available AntibioticsF. Buyle1, S. Metz-Gercek2, M. Struelens3 and the ABS team41 Ghent Univ. Hosp, Ghent, Belgium, 2 J.Kepler Univ, Linz, Austria;, 3Erasme Hosp., Univ. Libre de Bruxelles, Brussels, Belgium Background and objective Materials & Methods Results Conclusion Table 1. Demographic data A rational therapy of infection involves the selection of the most appropriate drug at its optimal dosage. In addition, the route of administration of the drug is important. Intravenous to oral switch is considered an important method to achieve a more rational utilisation of antibiotics. Several advantages have been associated with this strategy: less preparation time, easier drug administration, patient comfort, lower risk of bacteraemia and thrombophlebitis, savings in antibiotic costs and potential shortening in the length of hospital stay. Randomized clinical trials demonstrated the efficacy of intravenous to oral switch with highly bio-available antibiotics. The ABS International Quality Indicators (ABS QI) team has developed a set of structural and process indicators for evaluating the intensity of hospital antibiotic stewardship programmes. An indicator for intravenous to oral switch with highly bio-available antibiotics was tested for feasibility in European hospitals. • Study type and setting • Prospective observational study in 5 hospitals (2 in Austria, 2 in Belgium and 1 in Germany). • Inclusion criteria • Adult (>18 years) patients treated with intravenous fluoroquinolones, clindamycin, linezolid or metronidazole. • Outcome measurement • The percentage of patients with inappropriate treatment by intravenous route (= quality indicator) • Data availability and workload for datacollection • Criteria for evaluating inappropriate treatments • body temperature < 38°C during 24 hours • decreasing or normal leukocyte count • no unexplained tachycardia • intact functional gastro-intestinal tract (patient is able to eat) • absence of malabsorption (no vomiting, no diarrhoea) • a functional gastric feeding tube • no planned operation within 24 hours • no severe sepsis Objective Table 2. Results Patients receiving inappropriate IV therapy could eat (89%) or had a functional gastric tube available (11%). The availability of the data was 99%. The mean workload to collect the data was 35 minutes for each patient. References Conclusions The data demonstrate that this QI can be used across European acute care hospitals to assess the implementation of intravenous to oral switch with highly bio-available antibiotics. Inter-hospital variation in practice indicate that these indicator may be a useful target for quality of care improvement. 4ABS team: F. Allerberger, B. Byl, M. Costers, C. Ernes, R. Gareis, E. Hendrickx, R. Krause, W. Kern, A. Lechner, R. Mechtler, H. Mittermayer, H. Robays, D. Vogelaers email address for more information: franky.buyle@uzgent.be

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