Chest
Clinical Investigations: Infection: ArticlesA Prospective Randomized Study of Inpatient IV Antibiotics for Community-Acquired Pneumonia: The Optimal Duration of Therapy
Section snippets
Methods
This study was performed at the Bronx Veterans Affairs Medical Center (VAMC) and the Castle Point VAMC. The investigational review boards at both hospitals approved the study and all patients provided signed informed consent prior to enrollment.
Study Protocol
Study participants were recruited from patients admitted to an inpatient acute medical ward, after the treating emergency department or clinic physician determined that the CAP should not be treated in an outpatient setting. Patients with the hospital
Results
Seventy-three patients with 75 episodes of CAP were randomized (1:1:1) into 3 treatment groups from September 1993 to March 1995. The ethnic and racial make-up included 31 (42%) black, 24 (33%) white, and 18 (25%) Hispanic patients. Seventy-two were male and 1 was female. Two patients were enrolled twice, for two distinctly different episodes of CAP. Seventy-one were enrolled at the Bronx VAMC and 4 at the Castle Point VAMC.
The study was completed in 57 (76%) of the 75 episodes of CAP that were
Discussion
This study demonstrates that the course of IV antibiotic therapy for the treatment of CAP can be shortened without compromising a satisfactory clinical outcome. In addition, we have shown that, as a result of a shortened IV course of therapy, the hospital LOS can be reduced with substantial cost savings.
Response to antibiotic therapy was rapid and apparent within 2 days of initiating treatment. In therapeutic successes, clinical features such as fever and leukocytosis responded quickly and
Acknowledgment
We are indebted to Theodore L. Nappi, Pharm D, and Raymond Pecini, Pharm D, for pharmacy support, Darryl Williams for antimicrobial susceptibility testing, Michael P. Fitzmaurice for information management of the VA database, and Norma Kanarek, PhD, for information management of the HSCRC database.
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Cited by (0)
Supported m part by a grant from Glaxo Wellcome Inc.
This study was presented in part at the American Thoracic Society Meeting, Seattle, May 24, 1995, and the American College of Chest Physicians Meeting, New York, October 31, 1995.
revision accepted May 16.