Daily review of all IV antimicrobials is essential.
Any patient that fulfills Sepsis 6 criteria will receive IV antimicrobials as part of their initial treatment, but only very few will have an infection that can only be treated with IVs or excludes from early IVOST.
Use this IVOS algorithm to guide your daily review.
In the following circumstances IVOST is usually not appropriate:
- Sepsis - clinical signs of infection plus 2 or more SIRS criteria fulfilled
- Febrile neutropenia with neutrophil count < 0.5 x 109/L or other significant immunosuppression
- Specific illnesses may require prolonged IV treatment, e.g. meningitis or CNS infection, infective endocarditis, bone/joint infection
- Oral route compromised - vomiting, nil by mouth, reduced gastrointestinal absorption, mechanical swallowing disorder, unconscious.