Early switch to oral antibiotics and early discharge guidelines in the management of community‐acquired pneumonia

Abstract

The use of early switch and early discharge guidelines for CAP reduced the duration of i.v. antibiotics and LOS while maintaining high levels of safety and patient satisfaction.

Implication of Clinical Pathway Care for Community-Acquired Pneumonia in a Community Hospital: Early Switch from an Intravenous .BETA.-lactam Plus a Macrolide to an Oral Respiratory Fluoroquinolone

“…Second, we included patients who received prolonged treatment even after improvement in condition, because the criterion for discontinuing antibiotic treatment after switch therapy was not determined. Third, our study showed more prolonged LOS compared to other reports (7,9,23 T a b l e 5 . Co mp a r i s o n o f L e n g t h o f Ho s p i t a l S t a y , Ho s p i t a l Ch a r g e s , T …”

Novel Carbapenem Antibiotics for Parenteral and Oral Applications: In Vitro and In Vivo Activities of 2-Aryl Carbapenems and Their Pharmacokinetics in Laboratory Animals

“…Hospitalized patients with severe community-acquired infections should be treated initially with parenteral agents and could be switched to oral therapy when the clinical status improves. This switch therapy is gaining acceptance as a means of facilitating early discharge of patients from the hospital and reducing the overall costs of antimicrobial therapy (6)(7)(8). In the case of our 2-aryl carbapenems, this treatment strategy for community-acquired infections could also contribute to preserving the therapeutic efficacy of existing antipseudomonal carbapenems, which are key antibiotics for hospital-acquired infections.…”

“…Combinational development of parenteral and oral formulations of the same new class carbapenem, allowing a switch from parenteral to oral treatment, could contribute to early hospital discharge, decrease the cost of treatment (6)(7)(8), and reduce the risk of selection for cross-resistance to existing parenteral carbapenems in nosocomial pathogens.…”

Emergency Department and Inpatient Community-Acquired Pneumonia: Practical Decision Making and Management Issues

“…Once a patient is admitted for CAP, LOS is determined mostly by the duration of therapy [70]. Duration of therapy is extremely variable and many times not based on evidence.…”

“…These criteria included resolution of respiratory symptoms, resolution of fever, ability to tolerate oral antibiotics, normalizing white blood cell count, hemodynamic stability, stable or improving chest x-ray, stable comorbid diseases, baseline mental status, and no other sites of infection. A prospective study performed in 2007 showed a reduction in LOS of 0.74 days with no significant mortality events when several of these criteria were implemented [70]. Importantly, a high level of patient satisfaction was also achieved.…”