Switch therapy, or step-down therapy, is the concept of switching from an intravenous antibiotic to an oral preparation after a few days, once the condition of the patient has improved and the pathogen and its susceptibility have been determined. The orally active third-generation cephalosporin cefixime is a primary candidate for switch therapy owing to its very good efficacy and safety profile. Preliminary studies have shown excellent clinical outcomes with switch therapy to cefixime after 2–3 days for a variety of serious infections. Importantly, dramatic cost benefits have also been found, particularly with respect to reduced length of hospital stays. However, guidelines are required to indicate under what conditions switch therapy is appropriate, and awareness must be developed within hospitals among physicians, pharmacists and administrators alike.