1927. Preference for Intravenous vs. Oral Antibiotics at Hospital Discharge

BACKGROUND: This pilot study analyzes decisions of infectious diseases faculty: hospital discharge with oral vs. intravenous antibiotics in the context of an academic OPAT (outpatient parenteral antibiotic therapy) system. METHODS: We created a survey of eight patient scenarios culled from the OPAT records of Tufts Medical Center. Six case scenarios had clinical equipoise, while two control scenarios had a clear indication for discharge with intravenous antibiotics. Infectious diseases attendings affiliated with Tufts Medical Center were surveyed. Respondents were asked preferences for oral vs. intravenous antibiotics for each scenario, their confidence in each decision, and demographics. Providers’ antibiotic scores equaled the sum of responses to the six case scenarios (1 point for intravenous, 0 points for oral). Self-assessments of confidence in each decision were on a scale of 0 to 100% (100% indicating complete confidence). RESULTS: Nine of thirty responded to the survey. All reported US-based training/experience. All indicated preference for intravenous antibiotics in the two control scenarios. The average antibiotic score for all providers was 2.9. Factors trended with choosing oral antibiotics: ≤5 years of experience and >12 weeks of inpatient service per year. CONCLUSION: Although in reality all six case scenario patients had been discharged on intravenous antibiotics, respondents chose oral antibiotics almost 50% of the time. This pilot study demonstrates potential for antibiotic stewardship regarding intravenous recommendations. DISCLOSURES: All authors: No reported disclosures.