Abstract

The transition from intravenous (IV) to oral antibiotics is a critical decision in the management of infectious diseases. This transition can significantly impact patient outcomes, healthcare costs, and overall resource utilization. However, despite a wealth of evidence supporting the safety and efficacy of oral antibiotics in many situations, there remain barriers that impede this transition. These barriers may be rooted in both genuine medical-pharmaceutical factors and perceptual obstructions. Genuine medical-pharmaceutical factors include patient-specific characteristics, such as clinical stability, bioavailability of oral antibiotics, pharmacokinetics, and comorbidities, which influence the suitability of transitioning. Perceptual obstructions encompass healthcare provider beliefs, institutional practices, and historical biases that may lead to an overreliance on IV therapy even when oral antibiotics could be equally effective. This review will examine the existing body of literature to identify the key determinants of the decision-making process when transitioning patients from IV to oral antibiotics. It will critically assess the extent to which medical-pharmaceutical factors genuinely necessitate the use of IV antibiotics and the role of perceptual obstructions in perpetuating this practice. Furthermore, we will consider the potential benefits of early transition, such as reduced hospital length of stay, lower costs, and decreased risk of complications. By distinguishing between genuine medical-pharmaceutical factors and perceptual obstructions, this review aims to provide clinicians and healthcare institutions with a more comprehensive understanding of the decision-making process regarding IV to oral antibiotic transition. This insight may contribute to a shift in clinical practice towards optimizing antibiotic therapy, enhancing patient outcomes, and conserving valuable healthcare resources.