Editorials

Severe community acquired pneumonia

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.39050.672639.80 (Published 07 December 2006) Cite this as: BMJ 2006;333:1181
  1. Graham D Mills, infectious diseases physician (millsg@waikatodhb.govt.nz)1,
  2. Richard Laing, respiratory physician2
  1. 1Waikato Hospital, Hamilton, New Zealand 3204
  2. 2Christchurch Hospital, Christchurch, New Zealand 8001

    Early switch from intravenous to oral antibiotics is safe and reduces hospital stay

    Research into community acquired pneumonia over the past two decades has focused on developing tools to measure the severity of illness and which antibiotics to choose. Several tools can now help clinicians identify patients with severe community acquired pneumonia in clinical settings.1 In people with severe disease, international guidelines recommend early treatment with broad spectrum antibiotics, which provide cover for atypical pathogens.2

    It is less clear how best to manage patients during their stay in hospital. In this week's BMJ, a randomised trial by Oosterheert and colleagues reports the effect of switching from intravenous to oral antibiotics after three days rather than seven days in people with severe community acquired pneumonia.3 Until now, the lack of quality trial data in areas such as route of antibiotic administration, duration of treatment, and assessment of clinical stability has led to a conservative approach to …

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