Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Early Switch From Intravenous to Oral Cephalosporins in the Treatment of Hospitalized Patients With Community-Acquired Pneumonia

Early Switch From Intravenous to Oral Cephalosporins in the Treatment of Hospitalized Patients... Abstract Background: Switch therapy is defined as the early transition from intravenous to oral antibiotics during treatment of infection. This study was designed to evaluate the clinical outcome and length of stay of hospitalized patients with community-acquired pneumonia treated with an early switch from intravenous to oral third-generation cephalosporins. Methods: Patients with a new roentgenographic pulmonary infiltrate and at least two symptoms (cough, fever, or leukocytosis) were enrolled in this study and treated with intravenous ceftizoxime sodium (1 g every 12 hours) or ceftriaxone sodium (1 g every 24 hours). Patients were switched to oral cefixime (400 mg every 24 hours) as soon as they met the following criteria: (1) resolution of fever; (2) improvement of cough and respiratory distress; (3) improvement of leukocytosis; and (4) presence of normal gastrointestinal tract absorption. Results: Of the 120 patients enrolled, 75 (62%) had clinical data evaluated. Long-term follow-up showed that 74 patients (99%) were cured; one patient required readmission for further intravenous therapy. Mean duration of hospital stay was 4 days. Conclusions: This investigation demonstrated that an early switch to oral cefixime may be reasonable in hospitalized patients with community-acquired pneumonia who have already shown a good clinical and laboratory response to therapy with intravenous third-generation cephalosporins. This approach is clinically effective and minimizes hospital stay.(Arch Intern Med. 1995;155:1273-1276) References 1. Quintiliani R, Nightingale CH, Crowe HM, et al. Strategic antibiotic decision-making at the formulary level. Rev Infect Dis . 1991;13:S770-S777.Crossref 2. Ramirez JA, Burke JD, Ritter GW. Drug use evaluation for antimicrobial agents: program development and implementation. Pharm Ther . 1993;18:267-273. 3. Niederman MS, Bass JB, Campbell GD, et al. Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. Am Rev Respir Dis . 1993; 148:1418-1426.Crossref 4. Hirschman JV, Murray JF. Pneumonia and lung abscess. In: Braunwald E, Isselbacher KJ, Petersdorf RG, et al, eds. Harrison's Principles of Internal Medicine . New York, NY: McGraw-Hill International Book Co; 1987:1075-1082. 5. Pennington JE, Branch WT Jr. Community-acquired pneumonias. In: Branch P, ed. Office Practice of Medicine . Philadelphia, Pa: WB Saunders Co; 1987: 296-314. 6. Garibaldi RA. Epidemiology of community-acquired respiratory tract infections in adults: incidence, etiology, and impact. Am J Med . 1985;78:S32-S37.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Early Switch From Intravenous to Oral Cephalosporins in the Treatment of Hospitalized Patients With Community-Acquired Pneumonia

Loading next page...
 
/lp/american-medical-association/early-switch-from-intravenous-to-oral-cephalosporins-in-the-treatment-D0MhbETfgp
Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1995.00430120050006
Publisher site
See Article on Publisher Site

Abstract

Abstract Background: Switch therapy is defined as the early transition from intravenous to oral antibiotics during treatment of infection. This study was designed to evaluate the clinical outcome and length of stay of hospitalized patients with community-acquired pneumonia treated with an early switch from intravenous to oral third-generation cephalosporins. Methods: Patients with a new roentgenographic pulmonary infiltrate and at least two symptoms (cough, fever, or leukocytosis) were enrolled in this study and treated with intravenous ceftizoxime sodium (1 g every 12 hours) or ceftriaxone sodium (1 g every 24 hours). Patients were switched to oral cefixime (400 mg every 24 hours) as soon as they met the following criteria: (1) resolution of fever; (2) improvement of cough and respiratory distress; (3) improvement of leukocytosis; and (4) presence of normal gastrointestinal tract absorption. Results: Of the 120 patients enrolled, 75 (62%) had clinical data evaluated. Long-term follow-up showed that 74 patients (99%) were cured; one patient required readmission for further intravenous therapy. Mean duration of hospital stay was 4 days. Conclusions: This investigation demonstrated that an early switch to oral cefixime may be reasonable in hospitalized patients with community-acquired pneumonia who have already shown a good clinical and laboratory response to therapy with intravenous third-generation cephalosporins. This approach is clinically effective and minimizes hospital stay.(Arch Intern Med. 1995;155:1273-1276) References 1. Quintiliani R, Nightingale CH, Crowe HM, et al. Strategic antibiotic decision-making at the formulary level. Rev Infect Dis . 1991;13:S770-S777.Crossref 2. Ramirez JA, Burke JD, Ritter GW. Drug use evaluation for antimicrobial agents: program development and implementation. Pharm Ther . 1993;18:267-273. 3. Niederman MS, Bass JB, Campbell GD, et al. Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. Am Rev Respir Dis . 1993; 148:1418-1426.Crossref 4. Hirschman JV, Murray JF. Pneumonia and lung abscess. In: Braunwald E, Isselbacher KJ, Petersdorf RG, et al, eds. Harrison's Principles of Internal Medicine . New York, NY: McGraw-Hill International Book Co; 1987:1075-1082. 5. Pennington JE, Branch WT Jr. Community-acquired pneumonias. In: Branch P, ed. Office Practice of Medicine . Philadelphia, Pa: WB Saunders Co; 1987: 296-314. 6. Garibaldi RA. Epidemiology of community-acquired respiratory tract infections in adults: incidence, etiology, and impact. Am J Med . 1985;78:S32-S37.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 26, 1995

References