ArticleOpen forum infectious diseases2020
A Pathway for Community-Acquired Pneumonia With Rapid Conversion to Oral Therapy Improves Health Care Value.
Article in Open forum infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Streamlining antibiotic use in community acquired pneumonia: A quality improvement initiative.Journal of hospital medicine · 2026Observational
- The effectiveness of intravenous (IV) to oral (PO) antibiotic switch (IVOS) interventions in managing community- and hospital-acquired pneumonia-a systematic review.JAC-antimicrobial resistance · 2026Review
- Frequency of intravenous-to-oral antibiotic switch in VA hospitalized patients with community-acquired pneumonia.Infection control and hospital epidemiology · 2026Article
- Can we rely on artificial intelligence to guide antimicrobial therapy? A systematic literature review.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- One Health: Insights from Organizational & Social, Technology Assessment and Human Factors Perspectives.Yearbook of medical informatics · 2023Article
- A Statewide Collaborative Quality Initiative to Improve Antibiotic Duration and Outcomes in Patients Hospitalized With Uncomplicated Community-Acquired Pneumonia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Antibiotic Overuse and Stewardship at Hospital Discharge: The Reducing Overuse of Antibiotics at Discharge Home Framework.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Review
- Evaluation in Life Cycle of Information Technology (ELICIT) framework: Supporting the innovation life cycle from business case assessment to summative evaluation.Journal of biomedical informatics · 2022Review
- Improving management and antimicrobial stewardship for bacterial and fungal infections in hospitalized patients with COVID-19.Therapeutic advances in infectious diseaseReview
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence supports streamlined approaches for inpatients with community-acquired pneumonia (CAP) including early transition to oral antibiotics and shorter therapy. Uptake of these approaches is variable, and the best approaches to local implementation of infection-specific guidelines are unknown. Our objective was to evaluate the impact of a clinical decision support (CDS) tool linked with a clinical pathway on CAP care.
methodsThis is a retrospective, observational pre-post intervention study of inpatients with pneumonia admitted to a single academic medical center. Interventions were introduced in 3 sequential 6-month phases; Phase 1: education alone; Phase 2: education and a CDS-driven CAP pathway coupled with active antimicrobial stewardship and provider feedback; and Phase 3: education and a CDS-driven CAP pathway without active stewardship. The 12 months preceding the intervention were used as a baseline. Primary outcomes were length of intravenous antibiotic therapy and total length of antibiotic therapy. Clinical, process, and cost outcomes were also measured.
resultsThe study included 1021 visits. Phase 2 was associated with significantly lower length of intravenous and total antibiotic therapy, higher procalcitonin lab utilization, and a 20% cost reduction compared with baseline. Phase 3 was associated with significantly lower length of intravenous antibiotic therapy and higher procalcitonin lab utilization compared with baseline.
conclusionsA CDS-driven CAP pathway supplemented by active antimicrobial stewardship review led to the most robust improvements in antibiotic use and decreased costs with similar clinical outcomes.
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Registered trials
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