Clinical Pharmacology & Biopharmaceutics
Open Access

Antibiotics; Pharmacokinetics

Introduction

The administration of antibiotics is a fundamental aspect of modern medical practice, playing a crucial role in the treatment of various bacterial infections. Traditionally, intravenous (IV) antibiotics have been the standard of care for severe infections. However, in recent years, there has been a growing interest in transitioning patients from intravenous antibiotics to oral antibiotics as early as possible, provided it is safe and effective [1]. This transition offers several advantages, including reduced hospitalization costs and improved patient comfort. Nevertheless, the shift from intravenous to oral antibiotics is not always straightforward, and there are both genuine medical-pharmaceutical factors and perceptual obstructions that need to be considered.

Genuine medical-pharmaceutical factors

Infection severity: The decision to transition from IV to oral antibiotics largely depends on the severity of the infection. Severe infections, such as bloodstream infections, osteomyelitis, or endocarditis, may require an extended course of IV antibiotics to ensure adequate drug delivery and absorption [2]. Transitioning too early in these cases can be detrimental to the patient.

Drug bioavailability: Not all antibiotics are available in oral formulations with equivalent bioavailability to their IV counterparts. Some antibiotics may have poor oral bioavailability, making the transition challenging. Clinicians must ensure that an oral alternative is available and effective for the specific infection [3].

Patient condition: Patient factors, including gastrointestinal function, comorbidities, and allergies, play a significant role in the decision to transition to oral antibiotics. Patients with compromised gastrointestinal function or a history of allergic reactions to specific antibiotics may not be suitable candidates for oral therapy.

Pharmacokinetics and pharmacodynamics: Understanding the pharmacokinetics and pharmacodynamics of antibiotics is crucial. Factors like drug half-life, time-dependent or concentration-dependent killing, and resistance profiles need to be considered when switching antibiotics [3-4]. Oral antibiotics should maintain effective drug levels over time, equivalent to IV administration.

Perceptual obstructions

Healthcare provider reluctance: Some healthcare providers may be hesitant to transition from IV to oral antibiotics due to a perception that IV therapy is more potent or reliable. Overcoming this perceptual obstruction requires education and clinical evidence to support the safety and efficacy of oral antibiotics [5].

Patient expectations: Patients may also have expectations of receiving IV antibiotics, believing them to be superior [7]. Proper communication and education by healthcare professionals can help address these misconceptions and ensure patient cooperation in the transition [8].

Fear of treatment failure: Clinicians may be concerned about the possibility of treatment failure if they switch to oral antibiotics too soon. This fear is understandable but can be mitigated by carefully selecting appropriate candidates for transition and closely monitoring their progress [9,10].

Conclusion

The early transition from intravenous to oral antibiotics is a strategy with numerous benefits, including cost reduction and enhanced patient comfort. Nevertheless, medical-pharmaceutical factors and perceptual obstructions must be carefully considered. Genuine medicalpharmaceutical factors include infection severity, drug bioavailability, patient condition, and pharmacokinetic/pharmacodynamic properties. Perceptual obstructions involve healthcare provider reluctance, patient expectations, and the fear of treatment failure.

Balancing the medical-pharmaceutical aspects with overcoming perceptual obstructions requires evidence-based guidelines, robust patient education, and close monitoring of patients. By optimizing the transition from IV to oral antibiotics, healthcare providers can improve patient care while managing resources effectively.

1. Sessa B, Higbed L, Nutt D (2019) A review of 3, 4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. Front Psycho 10: 138.

Indexed at, Crossref, Google Scholar

2. Weston GK, Clunas H, Jimenez NC (2021) A review of the potential use of pinene and linalool as terpene-based medicines for brain health: discovering novel therapeutics in the flavours and fragrances of cannabis. Front Psycho 12: 583211.

Indexed at, Crossref, Google Scholar

3. Yaden DB, Eichstaedt JC, Medaglia JD (2018) The future of technology in positive psychology: methodological advances in the science of well-being. Front Psycho 9: 962.

Indexed at, Crossref, Google Scholar

4. Yaden DB, Eichstaedt JC, Medaglia JD (2018) The future of technology in positive psychology: methodological advances in the science of well-being. Front Psycho 9: 962.

Indexed at, Crossref, Google Scholar

5. Pollan M (2019) How to change your mind: What the new science of psychedelics teaches us about consciousness, dying, addiction, depression, and transcendence. J Psychoactive Drugs 132:37-38.

Indexed at, Crossref, Google Scholar

6. Castiglioni M, Laudisa F (2015) Toward psychiatry as a ‘human’science of mind. The case of depressive disorders in DSM-5. Front Psycho 5: 1517.

Indexed at, Crossref, Google Scholar

7. Castiglioni M, Laudisa F (2015) Toward psychiatry as a ‘human’science of mind. The case of depressive disorders in DSM-5. Front Psycho 5: 1517.

Indexed at, Crossref, Google Scholar

8. Gobb G, Inserr A, Greenway KT, Lifshitz M, Kirmayer LJ (2022) Psychedelic medicine at a crossroads: Advancing an integrative approach to research and practice. Transcultural Psychiatry 59: 718-724.

Indexed at, Crossref, Google Scholar

9. Balasubramaniam M, Telles S, Doraiswamy PM (2013) Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psycho 3: 117

Indexed at, Crossref, Google Scholar

10. Pieters T Snelders S (2009). Psychotropic drug use: Between healing and enhancing the mind. Neuroethics 2: 63-73.

Indexed at, Crossref, Google Scholar