An Evaluation of the intravenous to oral route conversion of antibiotics in a tertiary care hospital

Abstract

Background: Prolonged IV antibiotic use raises healthcare costs, hospital stays, and risks like infections, contributing to antimicrobial resistance. Timely IV-to-PO conversion is a safer, cost-effective alternative, yet remains underutilized in tertiary hospitals. This study assesses the frequency, outcomes, and cost savings of IV-to-PO antibiotic conversion. Materials and method: This six-month observational study in a tertiary care hospital involved 116 patients undergoing IV-to-PO antibiotic conversion. It assessed conversion strategies sequential, switch, and step-down therapy along with associated cost differences. Data on demographics, comorbidities, and antibiotic use were collected from case sheets, with cost analysis from hospital pharmacy and online sources. Results: The study population was 63% female, with 66% aged 18–59. Lower respiratory tract infections (27%) were the leading antibiotic indication, and diabetes (31%) was the most common comorbidity. Inj Ceftriaxone (34%) was the most used IV antibiotic, with IV-to-PO conversions mainly involving switch therapy (51.53%). Notable cost savings were found, particularly for Inj Meropenem (₹16,226) and Inj Linezolid (₹12,785). Conclusion: This study emphasizes the underutilization of IV-to-PO antibiotic conversion in tertiary hospitals, despite its cost-saving benefits. Switch therapy was most common, with significant savings from oral antibiotics. Structured conversion protocols can optimize antibiotic use, reduce hospital stays, minimize IV-related complications, and improve patient care in tertiary care setting.

Keywords: Intravenous-to-Oral Conversion, Antibiotics, Antimicrobial Stewardship, Cost Analysis, Tertiary Care Hospital, Switch Therapy.