Relais per os des antibiotiques en réanimation. Quand ? Comment ?

The sequential intravenous/oral therapy with or without the same antibiotics is encouraged in the medical literature. Nevertheless, this general practice is not really applicable in intensive care medicine because of: i) the severity of the infections (septic shock…), ii) the modified or unpredictable bioavailability at the early stage of the disease, iii) the absolute necessity of treatment with immediate effect. However, the switch from intravenous to per os therapy is possible in some clinical settings: i) community acquired pneumonia with severe hypoxemia, with a rapid clinical response to the initial intravenous treatment; ii) in case of use of fluoroquinolones or Linezolid® as antibiotics given after the intravenous initial antibiotherapy.