Abstract
Purpose
Despite the documented success of IV to oral anti-infective conversion programs, it is still unclear what the current standard of practice is in the US. A survey was conducted to evaluate the prevalence and characteristics of conversion programs throughout the nation.
Methods
A questionnaire was mailed to 890 randomly chosen hospital pharmacy directors. A preset cutoff date of 4 weeks from the initial mailing was set for responses; a second mailing was sent to those directors that did not respond initially.
Results
A total of 237 (27%) institutions responded. Of these, 74% had instituted conversion programs. More programs required prior physician notification compared with allowing pharmacists to proactively transition candidates (70% vs 30%, P < 0.001). The most common anti-infectives converted were the fluoroquinolones and fluconazole. Common conversion criteria included adequate oral intake and fever reduction. Characteristics associated with an increased likelihood of a conversion program were pharmacy residency programs (RR 1.3; 95% CI 1.132 to 1.477), clinical pharmacists (RR 1.6; 95% CI 1.262 to 2.123), ID specialty pharmacists (RR 1.3; 95% CI 1.153 to 1.499), ID physician consult service (RR 1.2; 95% CI 1.028 to 1.459), and teaching hospitals (RR 1.2; 95% CI 1.038 to 1.386). Hospitals with conversion programs employed a greater number of clinical pharmacists (P = 0.02). Multivariate analysis revealed that the presence of a clinical pharmacist was the most significant variable predicting implementation (P < 0.001).
Conclusion
The majority of hospitals responding to this survey had an intravenous to oral conversion program. While most programs still required prior physician notification, the presence of clinical pharmacists significantly influenced the prevalence of implementation and proactive transition.
Get full access to this article
View all access options for this article.