Some background : I was in the hospital recently for a couple of days and was able to talk and walk.. however, the doctors prescribed injections and IV canulisation over asking me to pop antibiotics and anti gastric medication. Is there a specific reason for hospitals to prefer it or is it just a matter of convenience?
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The first two things that pop in my head are that IV starts working much faster and the first pass effect which degrades approximately 70% of any medication orally.
So to be clear there is evidence that IV antibiotics tend to be overused. Even in cases where an initial IV dose is warranted switching over to oral can potentially be as effective. And while IV cannulation is pretty darn safe it still poses a slight chance for some complications.
What IV delivery does is give you an initial large dose that is rapidly spread throughout your bloodstream, so it begins to act faster. It should definitely be used at least initially where there is a potential for deep seated and/or severe infections. Oral doses are absorbed pretty quickly, but it can still be a couple hours to hit peak concentration vs IV which is basically instant. IV hits a higher concentration peak as well for the same amount of drug your body has to process, which is why you aren’t just doubling up on the oral dosage to hit the same peak concentration as the IV.
The preference for using IV in general then is mostly just thinking, if it’s better for the big stuff, it’s probably better for the small stuff and doing otherwise feels like giving sub par treatment. The cost and overhead associated with going IV just doesn’t enter the equation.
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I think an added point not mentioned is that if you’re sick enough to go to the hospital, they have to worry about you throwing up. Sure they can interrogate you about how nauseous you are and trust you that you know your own reactions to antibiotics ect. But you can’t throw it up if they give it to you in an IV. It gets to you fast, effectively, and without worrying about throwing it up and missing a dose. If your infection is bad enough to go to the hospital these are three things that really need to happen.
When I had an infection I went to the hospital for they gave me IV, I felt better, and then they sent me home with oral. They said I couldn’t go home on the oral antibiotics until they watched me eat, drink, and hold it down for 4 hours.
There are a number of medications that just have to be given IV. Like there’s not a stable way to get the proper dose into a pill that would survive your stomach to then be absorbed. Vancomycin comes to mind, as does toradol. Those are given by injection either intramuscular or IV because they must be.
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Injection is faster and more reliable. It doesn’t have to go through your stomach and liver first. If you don’t like it, did you ask for pills instead? They can prescribe both.
Your stomach is effectively a furnace for your body, it’s basically breaking down anything that gets consumed with acids and then a nutrient sludge is effectively sent down your gut where that sludge can pass closely with your blood to be absorbed.
A pill has to go through that entire process to be absorbed to some extent, and it needs to survive enough so that the contents can make it into your gut where you’ll start to pick-up the compounds of the medication.
An IV? Straight to the blood-stream, it’s far more precise and can provide an effect almost immediately.
A single blood-cell can travel throughout your entire body in about 45 seconds, a pill is exponentially slower.
I was in the hospital last year and had both, an IV and I took pills. One of my regular pills I couldn’t take because they were waiting for a spot to open up in the contrast MRI and that medication messed with the contrast portion, so I had to take an IV different version of the medication (similar but not the same) due to the hanging MRI.
But whatever you take in pill form, is much faster in iv form. It might depend on why you were in there and what medication it was.
Sometimes a patient should not have anything by mouth in case they end up needing surgery. Sometimes an iv medicine will work faster or better.
But most of the time…it’s because the patient expects to get a fancy IV medicine and will give us bad patient experience surveys because “the evil doctor didn’t care about my pain/illness and only bothered to order a pill that I could get at home!!!1”
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