Stopping antibiotic therapy and follow-up
In step 2.13 a decision was made to stop Linezolid at day 33 of a planned 42-day course of antibiotics (of which 26 days was Linezolid), because of adverse effects. …
Course: Intravenous to Oral Switch: Within Outpatient Parenteral Antibiotic Therapy (IVOST)
Case 3: Linezolid
A 73-year-old patient is admitted to orthopaedics with a two-day history of shivering and a swollen, warm and painful right wrist. The patient’s past medical history includes rheumatoid arthritis, which …
Early experience with nurse-led Linezolid monitoring
These slides describe our early experiences of specialist nurse-led Linezolid monitoring within our OPAT service. Method A service evaluation was performed. Patients were identified by review of OPAT service records. …
Trouble with Linezolid
The main course limiting adverse effects of using Linezolid in our experience are: General malaise, nausea/vomiting and mouth symptoms, which often occur together in a proportion of patients in the …
Linezolid monitoring
Linezolid is of the oxazolidone class of antibiotics and is prescribed for serious Gram-positive bacterial infections, including resistant infections such as those due to coagulase-negative staphylococci, MRSA and glycopeptide-resistant enterococci. …
Complex oral antibiotic therapy within OPAT – An introduction
The complex outpatient oral and parenteral antibiotic therapy (COPAT) service was established in Hull and East Yorkshire Hospitals NHS Trust (HEYHT), in 2010. The service was established to oversee the …
Advantages of oral versus IV antibiotic therapy
The potential advantages and disadvantages of using oral and IV antibiotics for serious infections such as endocarditis, bone and joint infections and neurosurgical infections in the outpatient environment are outlined …
Setting the Scene
Evidence has emerged from trials (POET & OVIVA) that an earlier switch to oral antimicrobials in bone and joint infections and endocarditis is as clinically effective as prolonged IV therapy, …
What is IVOST?
Intravenous (IV) to oral switch therapy (IVOST) is the clinical process by which a patients antibiotic prescription is safely changed from an intravenous (IV) to oral regimen at the optimal …
Summary of this case
The patient made rapid clinical progress. Although historically such patients would have received at least 2 weeks of IV therapy before switching to oral, in keeping with long-standing national clinical …
Issues to consider
The situation presented in case 2 is relatively complex, but reflects the complexity of many COPAT patients managed locally and elsewhere in the UK. The main issues to consider based …
What oral therapy would you choose?
Based on the story in step 1.6, which of the following is your preferred management strategy now (in a low MRSA endemicity environment)? a) Oral Flucloxacillin 1g every 6 hours …
Let’s consider this case again
A 27-year-old patient is admitted to hospital with general malaise and uncontrollable shivering, and a painful, red, warm and swollen foot following a minor injury two days prior (no foreign …
Establishing whether it is safe to switch
The principles of, and criteria for, switching from OPAT to oral therapy are similar to those applied to inpatients switching from IV to oral antibiotics. The following should be considered: …
These articles are from the online course:
Intravenous to Oral Switch: Within Outpatient Parenteral Antibiotic Therapy (IVOST)