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Assessment Of A Pharmacist-Led Antibiotic Time-Out For Transition Of Iv Vancomycin To Oral Linezolid, Mary S. Vogel, Jefferson Cua, Erika Dittmar, Timothy Gauthier, Kelsey N. Williams

Nursing & Health Sciences Research Journal

Introduction: Intravenous (IV) vancomycin requires therapeutic drug monitoring and line placement and may prolong hospital stay. Linezolid requires less monitoring, is orally bioavailable, and may expedite transitions of care. This study assessed the impact of a pharmacist-led antibiotic timeout for the transition from IV vancomycin to oral linezolid. Methods: This single-center, quasi-experimental study included admitted adult patients receiving IV vancomycin for over 48 hours. Patients receiving vasopressors, of immunocompromised status, or with specific antibiotic indications were excluded. The primary outcome was the pharmacist intervention acceptance rate. Secondary outcomes included median hospital length of stay, median antibiotic treatment days, and incidence …