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For many clinical conditions, decreasing hospital length of stay (LOS) has had a salutary effect on both hospital finances and, somewhat surprisingly, patient well-being. Severe community-acquired pneumonia (CAP) is usually treated initially with intravenous antimicrobials; this therapy is often continued until definite clinical cure is achieved, thus prolonging hospitalization despite early clinical response. Might an early switch to oral antibiotics be safe?
In a randomized, controlled, open-label, multicenter trial, researchers in the Netherlands compared cure rates, mortality, and LOS between 133 non–critical-care patients with severe CAP (pneumonia severity index class IV or V) who received 10 days of intravenous antibiotics (usually β-…