Oral or IV (intravenous) antibiotics? Which is the way forward?

When it comes to antibiotics for orthopaedic infections, you might have been offered intravenous antibiotics, but could oral antibiotics provide the same level of treatment or be even more effective? Dr Prash Vas, a leading London endocrinologist, explains how the OVIVA trial investigated this and the findings discovered.

Which type of antibiotic is traditionally used?

For many decades, bone and joint (orthopaedic) infections have mainly been treated via intravenous (IV) antibiotics for six weeks or longer.

The OVIVA trial

In 2013, a study concluded that as long as bacteria was being targeted by an antibiotic, the method of giving antibiotics had no considerable impact on the rate of recovery. The main objective of the OVIVA trial (Oral versus Intravenous Antibiotics for Bone and Joint Infection) was to investigate this 2013 finding.

The trial involved 1054 UK patients and observed the outcome of their treatment after one year. It compared patients who switched quickly from IV to oral antibiotics and patients who only received IV antibiotics. Of these patients, 83 per cent had lower limb infections and 17 per cent had foot infections.

Which was more successful? IV or oral antibiotics?

Despite the different administration methods and sites of infection, no notable difference in treatment success was found. Interestingly, a longer hospital stay and a higher rate of complications were noted for those who received only IV antibiotics compared to patients in the oral group, and thus oral antibiotics could be as effective for the patient.

While more studies are needed to confirm if oral antibiotics prove the same or better than IV antibiotics, the OVIVA trial represents an evolution in the treatment for bone and joint infections.

To discover how you can benefit from Dr Vas’ first-class patient care, visit his profile and arrange your first consultation.