Azithromycin monotherapy for patients hospitalized with community-acquired pneumonia: a 31/2-year experience from a veterans affairs hospital.

Content Provider	Semantic Scholar
Author	Feldman, Randy B. Rhew, David C. Wong, John Y. L. Charles, Robert Antoine Goetz, Matthew Bidwell
Copyright Year	2003
Abstract	BACKGROUND Current American Thoracic Society (ATS) community-acquired pneumonia treatment guidelines recommend azithromycin monotherapy for a limited subset of hospitalized patients. We evaluated the effectiveness of azithromycin monotherapy in a more generalized population of patients hospitalized with mild-to-moderate community-acquired pneumonia. METHODS We reviewed medical records from a Veterans Affairs facility for patients admitted with community-acquired pneumonia between December 1, 1997, and June 30, 2001, comparing those receiving azithromycin monotherapy, other ATS-recommended antibiotics, and non-ATS-recommended antibiotics. We excluded patients with immunosuppression, metastatic cancer, or hospital-acquired pneumonia. Outcome measures included times to stability, meeting criteria for change to oral therapy, and eligibility for discharge; length of stay; intensive care unit transfer; and mortality. Outcomes were adjusted for pneumonia severity, skilled nursing facility status, and processes of care. RESULTS A total of 442 patients were eligible for the study (221 in the azithromycin monotherapy group, 129 in the ATS group, and 92 in the non-ATS group). Times to clinical stability and to fulfilling early switch criteria were not statistically significantly different among the 3 groups. Mean time to fulfilling early discharge criteria was 2.48 days for patients receiving azithromycin monotherapy vs 2.84 days for those receiving ATS antibiotics (P =.008) and 2.58 days for those receiving non-ATS antibiotics (P =.64). Overall mean length of stay was shorter in the azithromycin monotherapy group (4.35 days) vs the ATS (5.73 days) (P =.002) and non-ATS (6.21 days) (P<.001) groups. Mortality, intensive care unit transfer, and readmission rates were similar across the groups. CONCLUSION Azithromycin monotherapy is equally as efficacious as other ATS-recommended regimens for treating hospitalized patients with mild-to-moderate community-acquired pneumonia.
Starting Page	634
Ending Page	637
Page Count	4
File Format	PDF HTM / HTML
Alternate Webpage(s)	https://archinte.jamanetwork.com/journals/INTEMED/articlepdf/215895/ioi20530.pdf
PubMed reference number	12885688v1
Volume Number	163
Issue Number	14
Journal	Archives of internal medicine
Language	English
Access Restriction	Open
Subject Keyword	Acquired Immunodeficiency Syndrome Azithromycin Eligibility Determination Exclusion Mycoplasma pneumonia Neoplasms Patients Pneumocystis jiroveci pneumonia Thoracic Outlet Syndrome community acquired pneumonia intensive care unit skilled nursing facility
Content Type	Text
Resource Type	Article