Northwestern Medicine
PO Alternatives to Commonly Prescribed IV Antibiotics(Those that are NOT automatic switches per IV to PO Policy)The following alternatives are not automatic switches per the IV to PO policy due to either poor oral bioavailability or lacking in antimicrobial coverage compared to the IV alternative. It is therefore even more important when recommending these alternatives to be sure that the patient is clinically improving and that the recommendation is appropriate. PO alternatives are indication- and organism-dependent.IV AntibioticPossible PO Alternative(s)*AmpicillinAmoxicillinAmpicillin/sulbactam (Unasyn)Amoxicillin/clavulanate (Augmentin)Piperacillin/tazobactam (Zosyn)Amoxicillin/clavulanate (Augmentin) plus Ciprofloxacin (Cipro)Cefazolin (Ancef, Kefzol)-Amoxicillin, Bactrim, or cephalexin* based on susceptibilities for E.coli (or other) UTIs-Cephalexin (Keflex)—Use for cellulitisCeftriaxone (Rocephin)-Cefuroxime (Ceftin)—Use for pneumonias-Cephalexin (Keflex)—Use for susceptible UTIs-Bactrim or ciprofloxacin for susceptible bugs for pyelonephritisDoxycyclineDoxycyclineNafcillin or Oxacillin-Dicloxacillin-Cephalexin (Keflex)Sulfamethoxazole/trimethoprim (Bactrim)Sulfamethoxazole/trimethoprim (Bactrim)Vancomycin for MRSADepending on susceptibility:-Sulfamethoxazole/trimethoprim (Bactrim)-Doxycycline-Clindamycin*Be sure to know what infection/bug they are treating so you can check that the PO alternative is covering the right thing and that susceptibilities, if available, matchAutomatic IV to PO Switches Approved per P&T Protocol:Intravenous MedicationOral ConversionLevofloxacin 750mg IVLevofloxacin 750mg POCiprofloxacin 400mg IVCiprofloxacin 500mg POCiprofloxacin 200mg IVCiprofloxacin 250mg POAzithromycin 500mg IVAzithromycin 500mg POAzithromycin 250mg IVAzithromycin 250mg POMetronidazole 500mg IVMetronidazole 500mg POMetronidazole 250mg IVMetronidazole 250mg POFluconazole 100mg IVFluconazole 100mg POFluconazole 200mg IVFluconazole 200mg POFluconazole 400mg IVFluconazole 400mg POLinezolid 600mg IVLinezolid 600mg POClindamycin 900mg IV q8hClindamycin 450mg PO q6hClindamycin 300-600mg IV q8hClindamycin 300mg PO q6hDoxycycline 100mg IVDoxycycline 100mg PO ................
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