[Oral antibiotics: even in severe infections?]

Intravenous antibiotic therapy has traditionally been considered the standard treatment for severe infections. However, recent research shows that early switching to oral antibiotics is often equivalent or even superior. This is made possible by new substances with high oral bioavailability and numerous clinical studies demonstrating the safety and efficacy of oral sequential therapy. Sequential therapy has advantages for patients (fewer catheter complications, better mobility and quality of life) and is beneficial both economically (lower costs, shorter hospital stays, fewer nosocomial infections) and ecologically (less waste). For various serious infections such as bone and joint infections, complicated urinary tract infections and severe pneumonia-as well as for endocarditis and bloodstream infections when certain conditions are met-studies show that switching to oral antibiotics is safe as soon as the patient is clinically stable. The selection of the appropriate oral agent is crucial and depends on bioavailability, the causative pathogen and the severity of the infection. Possible interactions with food and other medications must be taken into account.