Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines

McMullan, Brendan J., Andresen, David, Blyth, Christopher C., Avent, Minyon L., Bowen, Asha C., Britton, Philip N., Clark, Julia E., Cooper, Celia M., Curtis, Nigel, Goeman, Emma, Hazelton, Briony, Haeusler, Gabrielle M., Khatami, Ameneh, Newcombe, James P., Osowicki, Joshua, Palasanthiran, Pamela, Starr, Mike, Lai, Tony, Nourse, Clare, Francis, Joshua R., Isaacs, David and Bryant, Penelope A. (2016) Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines. Lancet Infectious Diseases, 16 8: E139-E152. doi:10.1016/S1473-3099(16)30024-X


Author McMullan, Brendan J.
Andresen, David
Blyth, Christopher C.
Avent, Minyon L.
Bowen, Asha C.
Britton, Philip N.
Clark, Julia E.
Cooper, Celia M.
Curtis, Nigel
Goeman, Emma
Hazelton, Briony
Haeusler, Gabrielle M.
Khatami, Ameneh
Newcombe, James P.
Osowicki, Joshua
Palasanthiran, Pamela
Starr, Mike
Lai, Tony
Nourse, Clare
Francis, Joshua R.
Isaacs, David
Bryant, Penelope A.
Title Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines
Journal name Lancet Infectious Diseases   Check publisher's open access policy
ISSN 1473-3099
1474-4457
Publication date 2016-08-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/S1473-3099(16)30024-X
Open Access Status Not yet assessed
Volume 16
Issue 8
Start page E139
End page E152
Total pages 14
Place of publication London, United Kingdom
Publisher The Lancet Publishing Group
Collection year 2017
Language eng
Abstract Few studies are available to inform duration of intravenous antibiotics for children and when it is safe and appropriate to switch to oral antibiotics. We have systematically reviewed antibiotic duration and timing of intravenous to oral switch for 36 paediatric infectious diseases and developed evidence-graded recommendations on the basis of the review, guidelines, and expert consensus. We searched databases and obtained information from references identifi ed and relevant guidelines. All eligible studies were assessed for quality. 4090 articles were identifi ed and 170 studies were included. Evidence relating antibiotic duration to outcomes in children for some infections was supported by meta-analyses or randomised controlled trials; in other infections data were from retrospective series only. Criteria for intravenous to oral switch commonly included defervescence and clinical improvement with or without improvement in laboratory markers. Evidence suggests that intravenous to oral switch can occur earlier than previously recommended for some infections. We have synthesised recommendations for antibiotic duration and intravenous to oral switch to support clinical decision making and prospective research.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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