Abstract

Het Patel*, Nishika Shah, Viraj Patel, Aneri Patel and Sandipkumar P. Bhatt

ABSTRACT

Introduction: The choice of drug administration route is critical for optimizing bioavailability and therapeutic effects. Intravenous (IV) administration is often preferred when oral absorption is challenging, but its overuse can lead to discomfort and infection risks. Rational switching from IV to oral therapy is essential for antimicrobial stewardship, cost minimization, and improved patient outcomes. Objective: Assessing the study of effectiveness of therapeutic switching on surgical patients by examining the prevalence, types, timeliness of switch, cost minimization, and length of hospital stay duration and simultaneously evaluating compliance with ICMR guidelines for Antimicrobial Stewardship Program during the transition from parenteral to oral therapy and adherence to ICMR Treatment Guidelines for Surgical Antimicrobial Prophylaxis, 2022. Methodology: A prospective observational study was conducted over six months in three general surgical hospitals, enrolling 98 participants. Data on demographics, therapy switching, daily progress, were recorded. Patients were monitored until discharge. Results: Out 98 participants, 43% underwent therapeutic switching, with sequential and switch therapy being the most common. As P-value was less than 0.05 which indicated difference in terms of mean length of hospital stay of those patients who were switched within 24 hrs and those who were switched within 24-48 hrs. Cost minimization was evident upon switching from injectable to oral therapy. It was observed that all the antimicrobial switch adhered to the guidelines outlined by ICMR for AMSP and SAP compliance was only 26%. Conclusion: Timely switching significantly reduces hospital stay and treatment costs. However, a major gap in adherence to ICMR SAP guidelines was observed, highlighting the need for better antimicrobial stewardship in surgical settings.