{
  "abstract": "Background and Importance Sequential therapy (ST), the early switch from intravenous to oral antimicrobial treatment, is a key strategy to optimise antimicrobial use, reduce complications associated with intravenous administration, and shorten hospital stays. Despite its proven clinical and economic benefits, implementation rates vary among different hospital departments. Understanding these differences is essential to identify barriers and improve adherence to antimicrobial stewardship recommendations.Aim and Objectives To evaluate the success and acceptance of pharmacist-led recommendations for ST involving antimicrobials with high oral bioavailability within an antimicrobial stewardship program. A comparative analysis was conducted between medical and surgical specialties to identify potential differences in acceptance and implementation rates.Material and Methods A retrospective descriptive study was performed over a one-year period, including all hospitalised patients treated with intravenous antimicrobials for ≥3 days who received an ST recommendation registered in an electronic stewardship tool. Data collected included type of antimicrobial, specialty (medical or surgical), acceptance or rejection of the recommendation, and cases without follow-up (end of treatment, discharge, or death). Antimicrobials considered for ST included levofloxacin, metronidazole, linezolid, clindamycin, fluconazole, ciprofloxacin, azithromycin, trimethoprim-sulfamethoxazole, doxycycline, moxifloxacin, and voriconazole.Results A total of 264 ST recommendations were recorded: 195 (73.8%) for medical specialties (MS) and 69 (26.2%) for surgical specialties (SS). The most frequently recommended antimicrobials were levofloxacin (35.2%), metronidazole (14.4%), clindamycin (13.6%), and linezolid (13.2%). In MS, follow-up was achieved in 124 cases; 79% were accepted. Ciprofloxacin, azithromycin, doxycycline, moxifloxacin, and voriconazole showed 100% acceptance. In SS, follow-up was possible in 40 cases; 55% were accepted, mainly with doxycycline, fluconazole, and voriconazole (100% acceptance).Conclusion and Relevance Pharmacist-driven interventions within antimicrobial stewardship programs facilitate early implementation of ST, helping to reduce complications from intravenous therapy. However, acceptance was notably lower in surgical specialties, highlighting the need for targeted educational initiatives to improve awareness of ST benefits. Greater acceptance among medical specialties suggests that increased exposure and familiarity with stewardship interventions may enhance implementation success.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofia, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "R Guzman Laiz"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "A Herreros Fernández"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "R Añez Castaño"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "I García Masegosa"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "P Pascual García"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "E Santos Lopez"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "M Almanchel Rivadeneyra"
    },
    {
      "affiliations": [
        "Hospital General Universitario Reina Sofía, Farmacia Hospitalaria, Murcia, Spain"
      ],
      "name": "E Urbieta Sanz"
    }
  ],
  "title": "4CPS-120 Impact of sequential therapy implementation in clinical practice: a comparative analysis between medical and surgical specialties",
  "uid": "e8712c14-4f3f-57f7-987f-0a5b38d18c2f"
}