When Should IV Antibiotics Be Switched to Oral?

Reviewed on 7/17/2020

What Are Antibiotics?

Intravenous antibiotics are typically reserved for deep-seated, life-threatening bacterial infections. Doctors generally switch people to oral antibiotics as their condition improves.
Intravenous antibiotics are typically reserved for deep-seated, life-threatening bacterial infections. Doctors generally switch people to oral antibiotics as their condition improves.

Antibiotics are medications used to help fight bacterial infections by targeting different weaknesses in the microbes, depending on the specific drug and organism. Antibiotics are not effective in treating viral infections such as the common cold and flu

Antibiotics come in several different forms:

  • Oral: pills, capsules, liquids
  • Topical: creams, ointments, lotions, sprays, drops
  • Injections: Single injection or intravenous injection

What Are Antibiotics Used For?

Antibiotics are used to fight infections caused by bacteria. Common bacterial infections that may be treated with antibiotics include:

What Are Types of Antibiotics?

The main groups of antibiotics include: 

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When Are Intravenous (IV) Antibiotics Used?

Intravenous (IV) antibiotics are used for:

  • Severe life-threatening infections, such as sepsis 
  • Deep seated infections in parts of the body where oral antibiotics are less effective, such as in the spinal fluid and bone
  • Infections resistant to oral antibiotics

When Should IV Antibiotics Be Switched to Oral?

There are a number of considerations to take into account when deciding to switch from intravenous (IV) antibiotics to oral antibiotics, including:

  • The patient’s response to the treatment
  • The patient’s immune status
  • Any co-existing illnesses
  • Allergies
  • The patient’s ability to absorb and tolerate oral medications 
  • The bioavailability of the medication 
  • The causative agent (bacterium) of the illness 
  • Whether an oral antibiotic is effective against a particular infectious agent
  • Whether the oral antibiotic will penetrate to the site of infection
  • Potential adverse effects 

Patients may be switched from IV antibiotics to oral medications when:

  • The patient’s condition has improved
  • Fever has improved
  • Blood pressure and blood flow is stable
  • The patient can tolerate oral intake of medications
  • There are no concerns about malabsorption
  • There is an appropriate oral antibiotic that acts the same or similarly to the IV drug

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Reviewed on 7/17/2020
References
Medscape Medical Reference

University of California San Diego

UK National Health Service

NPS Medicinewise

UpToDate.com