An early changeover led to a shortened hospital stay.
An early switch from IV to oral antibiotics can shorten the hospital stay of patients with community-acquired pneumonia (CAP), but this issue has been well studied only in small populations with mild-to-moderate disease. This Dutch trial involved a population with severe disease.
Subjects were 302 patients with severe CAP (defined by a standardized tool) who were not in the intensive care unit; they were randomized to either a minimum of 3 days of IV antibiotics followed — when clinically stable — by 7 days of oral antibiotics, or to 7 days of IV antibiotics. Patients were followed for 28 days. By day 3, 81% of the intervention patients were deemed stable enough to switch to oral antibiotics. Mortality was 4% in the intervention group and 6%…