ReviewBMJ open2022
From basic to advanced computerised intravenous to oral switch for paracetamol and antibiotics: an interrupted time series analysis.
Review in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Optimising antibiotic switching via forecasting of patient physiology.Nature communications · 2026Article
- Azithromycin and doxycycline intravenous and oral administrations before and after prescriber-facing alert for intravenous fluid conservation.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Sustainable Intensive Care: Do Not Forget IV to Oral Switch!Critical care medicine · 2026Article
- Cultivating global antimicrobial stewardship: prescribing quality and implementability insights from Portugal's First Hospital National Antimicrobial Prescribing Survey.Antimicrobial resistance and infection control · 2025Article
- Antimicrobial stewardship strategies for implementing the 2019 EUCAST "I" definition.BMC infectious diseases · 2025Article
- Evaluation and implementation of optimized antimicrobial dosing strategies in obese and underweight patients.Infection · 2024Article
- Bedside check of medication appropriateness (BED-CMA) as a risk-based tool for bedside clinical pharmacy services: A proof-of-concept study at the trauma surgery ward.Computational and structural biotechnology journal · 2023Article
- End-users feedback and perceptions associated with the implementation of a clinical-rule based Check of Medication Appropriateness service.BMC medical informatics and decision making · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEarly switch from intravenous to oral therapy of bioequivalent drugs has major advantages but remains challenging. At our hospital, a basic clinical rule was designed to automatically alert the physician to review potential intravenous to oral switch (IVOS). A rather low acceptance rate was observed. In this study, we aimed to develop, validate and investigate the effect of more advanced clinical rules for IVOS, as part of a centralised pharmacist-led medication review service. DESIGN AND
settingA quasi-experimental study was performed in a large teaching hospital in Belgium using an interrupted time series design.
interventionA definite set of 13 criteria for IVOS, focusing on the ability of oral absorption and type of infection, was obtained by literature search and validated by a multidisciplinary expert panel. Based on these criteria, we developed a clinical rule for paracetamol and one for ten bioequivalent antibiotics to identify patients with potentially inappropriate intravenous prescriptions (PIVs). Postintervention, the clinical rule alerts were reviewed by pharmacists, who provided recommendations to switch in case of eligibility. PRIMARY AND SECONDARY OUTCOME MEASURES: A regression model was used to assess the impact of the intervention on the number of persistent PIVs between the preintervention and the postintervention period. The total number of recommendations, acceptance rate and financial impact were recorded for the 8-month postintervention period.
resultsAt baseline, a median number of 11 (range: 7-16) persistent PIVs per day was observed. After the intervention, the number reduced to 3 (range: 1-7) per day. The advanced IVOS clinical rules showed an immediate relative reduction of 79% (incidence rate ratio=0.21, 95% CI 0.13 to 0.32; p<0.01) in the proportion of persistent PIVs. No significant underlying time trends were observed during the study. Postintervention, 1091 recommendations were provided, of which 74.1% were accepted, resulting in a total 1-day cost saving of €4648.35.
conclusionsWe showed the efficacy of advanced clinical rules combined with a pharmacist-led medication review for IVOS of bioequivalent drugs.
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