Multi-Disciplinary Approach and Need of Intravenous to Oral Conversion in Hospital and Role of the Pharmacist in Rational Use of Antimicrobials

Multi-disciplinary approach and IV to oral conversion are important aspects of rational use of antimicrobials in hospitals. Most of the time patients admitted to the hospital with any serious condition are first given an intra venous route of administration. Some of patient will continue with IV where as some will be converted to oral administration. The shift from iv to oral depends on disease severity, co-morbidity, and drug bioavailability. Body weight-based conversion of intravenous to oral should be practiced for effective and tolerable treatment and for good therapeutic outcome. But this conversion from IV to oral is not applicable in all patients whose GI absorption is altered. IV administration is mostly effective in highly infected patient and in septicemic for their early recovery. But long-term iv administration leads to iv abuse that includes phlebitis, infiltration, hematoma. Prolonged iv administration of psychotropic drugs like Carbamazepine leads to sleep abnormalities, decreased gait, anxiety disorders. Nowadays irrational use of IV antibiotics is increasing, hence to avoid irrational use of antibiotics IV should be converted to oral at proper time and guidelines. Role of clinical pharmacist in switching IV to oral includes monitoring, educating and practicing as per the guidelines.