Background Due to several factors intravenous drug treatments (IDT) in hospitals are not always changed to oral administration when possible.
Purpose To determine the frequency of IDT that can be switched to oral administration in a tertiary care hospital and to estimate savings that could be made by switching the administration route of selected drugs.
Materials and methods We collected prescription data on a randomly chosen weekday of all inpatients from hospital units with unit dose drug distribution. Four drugs with oral bioavailability greater than 75% were chosen for the study (acetaminophen/paracetamol, levofloxacin, omeprazole, ranitidine). Variables collected were: Prescribing service, medical specialty, type of diet, number of prescribed drugs administered orally, number of days of IDT and prescription of antiemetics. Data was obtained from the pharmacy inpatient program (Farmatools) and the hospital diet request system (Dietools). A drug was considered for intravenous-to-oral switchig when the patient was eating normally, had two or more drugs prescribed for oral administration, had received IV treatment for more than a day and had no antiemetic drugs prescribed. Cost evaluation was based on drug prices obtained by the institution.
Results Prescriptions of 193 patients were analysed and 169 of them were eligible to be changed to oral administration. Classified by active ingredient they corresponded to: paracetamol in 88 prescriptions out of 109 (80%), levofloxacin in 6 out of 25 (24%), omeprazole in 43 out of 74 (58%) and ranitidine in 32 out of 41 (78%). Estimated savings of paracetamol prescriptions on the day of study added up to 296.45 €, annual saving estimation of 108,204 €. Savings due to levofloxacin would be 11.82€ (4,314 € per year), omeprazole 29.67€ (10,829 € per year) and ranitidine 12.93 € (4,719 € per year).
Conclusions Implementation and optimisation of an intravenous-to-oral switch programme in a selected group of drugs would not only reduce complications associated with intravenous administration but also drug costs.
No conflict of interest.
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