IV to PO Antibiotic Guideline
Step Down Therapy

Step Down Therapy


  1. Patient has received at least 48 hours of IV antimicrobial treatment
  2. Patient is able to tolerate oral medications AND has no factors impairing oral absorption
  3. Patient is hemodynamically stable and demonstrating signs of clinical improvement
  • Systemic exposure is not equivalent between oral and IV routes of the same antimicrobial in different dosage forms
  • Step-down therapy covers a similar spectrum of organisms as the IV route and should be chosen based on the type and site of infection
  • Consult ASP for assistance in stepping down therapy as needed