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Titolo:
EARLY TRANSITION TO ORAL ANTIBIOTIC-THERAPY FOR COMMUNITY-ACQUIRED PNEUMONIA - DURATION OF THERAPY, CLINICAL OUTCOMES, AND COST-ANALYSIS
Autore:
OMIDVARI K; DEBOISBLANC BP; KARAM G; NELSON S; HAPONIK E; SUMMER W;
Indirizzi:
LOUISIANA STATE UNIV,MED CTR,1542 TULANE AVE NEW ORLEANS LA 70112 WAKE FOREST UNIV,BOWMAN GRAY SCH MED WINSTON SALEM NC 27157
Titolo Testata:
Respiratory medicine
fascicolo: 8, volume: 92, anno: 1998,
pagine: 1032 - 1039
SICI:
0954-6111(1998)92:8<1032:ETTOAF>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
HOSPITALIZED-PATIENTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
27
Recensione:
Indirizzi per estratti:
Citazione:
K. Omidvari et al., "EARLY TRANSITION TO ORAL ANTIBIOTIC-THERAPY FOR COMMUNITY-ACQUIRED PNEUMONIA - DURATION OF THERAPY, CLINICAL OUTCOMES, AND COST-ANALYSIS", Respiratory medicine, 92(8), 1998, pp. 1032-1039

Abstract

Our objective was to compare therapeutic outcome and analyse cost-benefit of a 'conventional' (7-day course of i.v. antibiotic therapy) vs.an abbreviated (2-day i.v. antibiotic course followed by 'switch' to oral antibiotics) therapy for in-patients with community-acquired pneumonia (CAP). We used a multicenter prospective, randomized, parallel group with a 28 day follow-up, at the University-based teaching hospitals: The Medical Center of Louisiana in New Orleans, LA and hospitals listed in the acknowledgement. Ninety-five patients were randomized to receive either a 'conventional' course of intravenous antibiotic therapy with cefamandole Ig i.v. every 6 h for 7 days (n=37), or an abbreviated course of intravenous therapy with cefamandole (1 g i.v. every 6 h for 2 days) followed by oral therapy with cefaclor (500 mg every 8 hfor 5 days). No difference was found in the clinical courses, cure rates, survival or the resolution of the chest radiograph abnormalities among the two groups. The mean duration of therapy (6.88 days for the conventional group compared to 7.30 days for the early oral therapy group) and the frequencies of overall symptomatic improvement (97% vs. 95%, respectively) were similar in both groups. Patients who received early oral therapy had shorter hospital stays (7.3 vs. 9.71 days, P=0.01), and a lower total cost of care ($2953 vs. $5002, P<0.05). It was concluded that early transition to an oral antibiotic after an abbreviated course of intravenous therapy in CAP is substantially less expensive and has comparable efficacy to conventional intravenous therapy. Altering physicians' customary management of hospitalized patients with CAP can reduce costs with no appreciable additional risk of adverse patient outcome.

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Documento generato il 24/11/20 alle ore 13:52:23