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antibiotic therapy

Adverse effects: - 25% of patients who receive at least 2 weaks of IV antibiotics develop eosinophilia [6] - only vancomycin associated with excess risk of dress DRESS [6] Management: - empiric antibiotic therapy should be tailored to provide the narrowist spectrum antibiotic possible as soon as culture results become available [1,2] - blood cultures should be drawn prior to initiation of intravenous antibiotic therapy - all patients on IV antibiotics with intact GI system whose clinical status is improving should be considered for switch to oral therapy [1,2] - oral antibiotics can be used to treat serious infections [3] - continued inpatient monitoring of stable patients after transition from IV to oral antibiotics does not improve outcomes [1] - outpatient parenteral antibiotics may be appropriate for selected patients [1]

Related

antibiotic allergy antibiotic prescribing practices; antibiotic overuse; outpatient parenteral antibiotics antibiotic prophylaxis duration of antibiotic therapy failure of antibiotic therapy

Specific

empiric antibiotic therapy intravenous antibiotic therapy

General

pharmacologic therapy

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
  2. Masterton RG Antibiotic de-escalation. Crit Care Clin. 2011 Jan;27(1):149-62 PMID: 21144991
  3. Cunha BA. Oral antibiotic therapy of serious systemic infections. Med Clin North Am. 2006 Nov;90(6):1197-222. Review. PMID: 17116444
  4. Chapman AL. Outpatient parenteral antimicrobial therapy. BMJ. 2013 Mar 26;346:f1585. Review. PMID: 23532865
  5. Seaton RA, Barr DA. Outpatient parenteral antibiotic therapy: principles and practice. Eur J Intern Med. 2013 Oct;24(7):617-23. Review. PMID: 23602223
  6. Blumenthal KG et al. Peripheral blood eosinophilia and hypersensitivity reactions among patients receiving outpatient parenteral antibiotics. J Allergy Clin Immunol 2015 Nov; 136:1288. PMID: 25981739
  7. Cyriac JM, James E. Switch over from intravenous to oral therapy: A concise overview. J Pharmacol Pharmacother. 2014 Apr;5(2):83-7. Review. PMID: 24799810 Free PMC Article