The effectiveness of intravenous (IV) to oral (PO) antibiotic switch interventions in managing community- and hospital-acquired pneumonia—a systematic review
Abstract
Prolonged intravenous (IV) antibiotic therapy, compared to oral (PO) therapy in hospitalised patients with pneumonia increases healthcare cost and hospital length of stay.[1] Antimicrobial stewardship (AMS) interventions promoting timely intravenous-to-oral (IV-to-PO) antibiotic conversion, may reduce healthcare burden without compromising patient outcomes.[2] However, the optimal design, implementation, and long-lasting effect of such interventions remain unclear across different healthcare settings in respiratory medicine.
To evaluate the effectiveness of interventions designed to improve IV-to-PO antibiotic switching in the management of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP).
This review was registered with PROSPERO (CRD420251039180). Electronic databases (PubMed, Scopus, Web of Science, The Cochrane Library) were searched for studies published from 1995 to 2024. Keywords such as “community-acquired pneumonia and ‘antimicrobial stewardship’ were used. Eligible studies focused on CAP and/or HAP management or antimicrobials indicated for respiratory infections. Two reviewers independently screened study titles/abstracts and then full-text articles using a priori inclusion/exclusion criteria. Any discrepancies were resolved through discussion with a third reviewer. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Study characteristics including country of origin, patient demographics, intervention type, and reported…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 17 participants or records.
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