Skip to 0 minutes and 4 secondsWelcome to this course that focuses on the switch from intravenous to oral antibiotic therapy, within the context of OPAT. And also focuses on an expanding area of OPAT practise, which is the monitoring of complex oral antibiotic regimens. My name is Gavin Barlow. I'm a senior clinical lecturer at the Hull York Medical School in the University of York, and also an honorary consultant in infection at Hull University teaching hospitals here in the UK. So as I say, the course will focus on that important area of OPAT practise, which is switching from intravenous antibiotics to oral antibiotics.

Skip to 0 minutes and 48 secondsBut also an expanding area of practise, particularly in light of recently published trials, such as the OVIVA trial in orthopaedic infection, and the POET trial in endocarditis-- namely the monitoring of complex oral antibiotic regimens. So thanks very much for signing up to the course. I hope you enjoy it. And I hope it's useful for your clinical practise. Please send us your feedback-- so tell us what you like, tell us what you don't like about the course so we can improve it in the future. And good luck in tackling the course and finishing the four weeks.

Welcome to Week 1

Welcome to this course on Intravenous (IV) to Oral [Antimicrobial] Switch Therapy (IVOST) and the monitoring of complex oral antimicrobial therapy within the context of an Outpatient Parenteral Antibiotic Therapy (OPAT) service.

The course will cover two main areas:

  1. Switching from IV to oral antimicrobials, which is a key clinical process of care when delivering OPAT.
  2. Delivering a complex oral antimicrobial monitoring service within the OPAT setting, which is increasingly called COPAT (Complex [Outpatient] Oral and Parenteral Antimicrobial Therapy).

The latter is an important emerging area of expanded practice for OPAT services within the UK, particularly in the context of recently published clinical trials such as POET (endocarditis) and OVIVA (bone and joint infections), both of which suggest that early IVOST is as safe and effective as prolonged IV therapy for selected patients. Week 1 will focus on IVOST, with other areas covered in subsequent weeks.

I strongly encourage you to engage with your fellow learners during the week, by using the comments facility in each step. By doing so, you will enrich your learning and that of fellow learners, by reading about the environment they work in, and their local clinical practices and experiences.

Anyway, without further ado, I hope you enjoy the week and course and that you have a useful learning experience. We are very keen to receive your feedback so we can improve the week and course for future learners.

If there are additional resources you think future learners will find helpful, please let us know in the comments.

The very best of wishes for this week and the course and beyond,

Gavin Barlow

Please note that this resource should not be used as a de facto information source for drug-drug interactions, adverse effects, etc. A purpose-written resource, such as the British National Formulary, should always be consulted to inform day-to-day clinical practice decisions.


Main learning outcomes for week 1:

  • Understand the advantages and disadvantages of intravenous compared to oral antibiotic therapy in the OPAT setting.

  • Understand the principles of switching patients from intravenous to oral antibiotic therapy in the OPAT setting.

  • Understand the complexity and the need for detailed patient assessment when switching from intravenous to oral therapy in the OPAT setting.

  • Develop a basic understanding of the concept of shared decision-making and think about how one might incorporate this into clinical practice.

You can use the progress page to see how you are doing in the course.

Please find a downloadable PDF at the bottom of the page containing a glossary of terms relevant to the course.


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Intravenous to Oral Switch: Within Outpatient Parenteral Antibiotic Therapy (IVOST)

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