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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Slee, Peter H. Th J. Kaasjager, Karin Bonten, Marc J. M. Schneider, Margriet M. E. Lammers, Jan-willem J. Hoepelman, Andy I. M. Hustinx, Willem M. N. Prins, Jan M. Kramer, Mark H. H. Oosterheert, Jan Jelrik Buskens, Erik |
| Description | Author Affiliation: Oosterheert JJ ( Department of Internal Medicine and Infectious Diseases, University Medical Centre, PO Box 85500, 3508 GA Utrecht, Netherlands.); |
| Abstract | Objectives To compare the effectiveness of an early switch to oral antibiotics with the standard 7 day course of intravenous antibiotics in severe community acquired pneumonia. Design Multicentre randomised controlled trial. Setting Five teaching hospitals and 2 university medical centres in the Netherlands. Participants 302 patients in non-intensive care wards with severe community acquired pneumonia. 265 patients fulfilled the study requirements. Intervention Three days of treatment with intravenous antibiotics followed, when clinically stable, by oral antibiotics or by 7 days of intravenous antibiotics. Main outcome measures Clinical cure and length of hospital stay. Results 302 patients were randomised (mean age 69.5 (standard deviation 14.0), mean pneumonia severity score 112.7 (26.0)). 37 patients were excluded from analysis because of early dropout before day 3, leaving 265 patients for intention to treat analysis. Mortality at day 28 was 4% in the intervention group and 6% in the control group (mean difference 2%, 95% confidence interval −3% to 8%). Clinical cure was 83% in the intervention group and 85% in the control group (2%, −7% to 10%). Duration of intravenous treatment and length of hospital stay were reduced in the intervention group, with mean differences of 3.4 days (3.6 (1.5) v 7.0 (2.0) days; 2.8 to 3.9) and 1.9 days (9.6 (5.0) v 11.5 (4.9) days; 0.6 to 3.2), respectively. Conclusions Early switch from intravenous to oral antibiotics in patients with severe community acquired pneumonia is safe and decreases length of hospital stay by 2 days. Trial registration Clinical Trials {"type":"clinical-trial","attrs":{"text":"NCT00273676","term_id":"NCT00273676"}}NCT00273676. |
| ISSN | 09598138 |
| e-ISSN | 17561833 |
| Journal | BMJ (British Medical Journal) |
| Issue Number | 7580 |
| Volume Number | 333 |
| Language | English |
| Publisher | British Medical Journal Publishing Group |
| Publisher Date | 2006-12-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Amoxicillin Therapeutic Use Anti-Bacterial Agents Administration & Dosage Cephalosporins Clavulanic Acid Community-Acquired Infections Drug Therapy Pneumonia, Bacterial Administration, Oral Adolescent Drug Combinations Infusions, Intravenous Time Factors Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Medicine |
| Content Type | Text |
| Resource Type | Article |
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