Antimicrobial switch therapy

Doxycycline (use in combination with one or two additional antimicrobials listed below) Intravenous treatment initially (lOOmg q 12h) in combination with one or two additional antimicrobials Switch to oral when appropriate (lOOmg PO BID) Intravenous treatment initially >8 years and >45 kg (lOOmg q 12h) >8 years and <45 kg (2.2 mg/kg q 12 h) <8 years (2.2 mg/kg ql2h) Switch to oral therapy when appropriate >8 years and >45kg (lOOmg PO BID) >8 years and <45 kg (2.2 mg/ kg PO BID) <8 years (2.2 mg/kg PO BID) ... 

On the fifth day of antimicrobial treatment, determine if parenteral antimicrobial agents can be switched to oral agents to complete therapy. 

The total duration of antimicrobial therapy is typically 4 to 6 weeks. Therapy is often administered intravenously for 1 or 2 weeks and then switched to the oral route. 

The most common drug-related adverse experiences in patients treated with ertapenem, including those who were switched to therapy with an oral antimicrobial, were diarrhea, infused vein complication, nausea, headache, vaginitis, phlebitis/thrombophlebitis, and vomiting. 

Adults Ciprofloxacin, 400mg every 12h or Doxycycline 100 mg every 12h and one or two additional antimicrobials IV treatment initially. Switch to oral antimicrobial therapy when clinically appropriate Ciprofloxacin 500 mg po BID or Doxycycline 100 mg po BID. Continue for 60 days (IV and po combined) ... 

The proper route of administration for an antimicrobial depends on the site of infection. Parenteral therapy is warranted when patients are being treated for febrile neutropenia or deep-seated infections such as meningitis, endocarditis, and osteomyelitis. Severe pneumonia often is treated initially with intravenous antibiotics and switched to oral therapy as clinical improvement is evident. Patients treated in the ambulatory setting for upper respiratory tract infections (e.g., pharyngitis, bronchitis, sinusitis, and otitis media), lower respiratory tract infections, skin and soft tissue infections, uncomplicated urinary tract infections, and selected sexually transmitted diseases may receive oral therapy. 

---