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
2. Absorption. If there are concerns about poor gut function and not absorbing oral drugs properly (enteropathy, sepsis etc) 2/4
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
Metronidazole, Rifampicin, Doxycycline, Ciprofloxacin, Clindamycin (also all generally have amazing tissue penetration!)
IV ain’t magic. Dose it oral when you can! 4/4