My Authors
Read all threads
There’s a lot of magical thinking about IV antibiotics 🧙‍♂️

The fact is, the bug doesn’t care how the drug got in. It only cares how much drug gets to it!

There’s actually only a few reasons you ever have to give them IV over oral. Let’s take a look at some #FOAMed 1/4
1. Speed. If you have a life/limb threatening infection and need peak plasma levels in seconds/minutes, not minutes to hours (Sepsis, nec fasc etc)

2. Absorption. If there are concerns about poor gut function and not absorbing oral drugs properly (enteropathy, sepsis etc) 2/4
3. No gut access. Patient is nil by mouth (duh)

4. Coverage. There are no oral options to sufficiently cover a particularly resistant bacteria (e.g. Pseudomonas, ESBLs)

5. Dose. You need to give such a whopping dose it wouldn’t be tolerated orally 💊 3/4
Some drugs have such amazing oral absorption that giving them IV if the patient can swallow them is criminal!

Metronidazole, Rifampicin, Doxycycline, Ciprofloxacin, Clindamycin (also all generally have amazing tissue penetration!)

IV ain’t magic. Dose it oral when you can! 4/4
Missing some Tweet in this thread? You can try to force a refresh.

Enjoying this thread?

Keep Current with Alasdair Munro

Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

Twitter may remove this content at anytime, convert it as a PDF, save and print for later use!

Try unrolling a thread yourself!

how to unroll video

1) Follow Thread Reader App on Twitter so you can easily mention us!

2) Go to a Twitter thread (series of Tweets by the same owner) and mention us with a keyword "unroll" @threadreaderapp unroll

You can practice here first or read more on our help page!

Follow Us on Twitter!

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just three indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!