What is the standard treatment schedule for a course of beta-lactams and how does the de-escalation protocol alter the schedule? Does de-escalation mean a lower dose of drug on the same schedule or same dose but fewer treatments or is it a mixture?
There isn’t really an accepted “standard” as such, however antibiotic regimes usually fall into three stages::
1. Empiric - when the bug is unknown, therapy is directed generally depending on the suspected site of infection (eg different for lungs vs urine)
2. Definitive - when you have determined the bug, select the most targeted antibiotic to maximise efficacy (often involves narrowing spectrum)
3. Oral switch - if initial stages given intravenously, the antibiotic can usually be switched to its oral version, or a suitable oral alternative if no oral version exists
So whilst narrowing of spectrum is almost always desirable, it doesn’t always happen.
What is the standard treatment schedule for a course of beta-lactams and how does the de-escalation protocol alter the schedule? Does de-escalation mean a lower dose of drug on the same schedule or same dose but fewer treatments or is it a mixture?
There isn’t really an accepted “standard” as such, however antibiotic regimes usually fall into three stages::
1. Empiric - when the bug is unknown, therapy is directed generally depending on the suspected site of infection (eg different for lungs vs urine)
2. Definitive - when you have determined the bug, select the most targeted antibiotic to maximise efficacy (often involves narrowing spectrum)
3. Oral switch - if initial stages given intravenously, the antibiotic can usually be switched to its oral version, or a suitable oral alternative if no oral version exists
So whilst narrowing of spectrum is almost always desirable, it doesn’t always happen.