Intravenous-to-oral antibiotic switch therapy. A cost-effective approach.

Every attempt should be made to switch hospitalized infectious-disease patients from intravenous to oral antibiotic therapy as soon as clinical improvement makes it possible. In addition to tremendous cost savings, the advantages of oral therapy are impressive and include a decrease in the number of nosocomial infections, shorter length of hospital stay, and lower incidence of intravenous-line infections. The main barrier to the acceptance of switch therapy is a lack of understanding of its efficacy, safety, and cost advantages. The wide-scale institution of managed care has resulted in the dawning of the era of oral antimicrobial therapy. Everything from infective endocarditis in intravenous drug abusers to neuroborreliosis may be treated effectively by the oral route.