ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Intravenous to Oral Antibiotic Switch Therapy Among Patients Hospitalized With Community-Acquired Pneumonia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 30 citations in OpenAlex.
- Article
- Inpatients' willingness to accept antibiotic intravenous-to-oral switch therapy and its influencing factors: a qualitative study based on the Health Belief Model.BMC infectious diseases · 2026Article
- Monotherapy versus combination therapy in severe Legionella pneumonia: a multicenter retrospective observational study.Critical care (London, England) · 2026Observational
- Frequency of intravenous-to-oral antibiotic switch in VA hospitalized patients with community-acquired pneumonia.Infection control and hospital epidemiology · 2026Article
- Simulating an intravenous-to-oral cefotaxime-to-cefditoren/cefuroxime switch: anFrontiers in pharmacology · 2026Article
- Cost analysis of a sequential antimicrobial therapy protocol in patients with pneumonia: A multicenter study.PloS one · 2026Observational
- Cultivating global antimicrobial stewardship: prescribing quality and implementability insights from Portugal's First Hospital National Antimicrobial Prescribing Survey.Antimicrobial resistance and infection control · 2025Article
- Comparison of length of stay in community-acquired pneumonia patients who fit protocol for pharmacy driven de-escalation of ceftriaxone to standard of care.Exploratory research in clinical and social pharmacy · 2025Article
- Article
- Transitioning to oral therapy compared to IV inAnnals of medicine and surgery (2012) · 2025Article
- Molecular Insights into RNA Modifications and Their Role in Shaping Immune Responses and Tumor Microenvironments.Current gene therapy · 2025Review
- Article
- Optimizing Antimicrobial Use in Japan: Strategies for Dosage, Combination Therapy, De-Escalation, Oral Switching, Duration, and Guideline Adherence.Clinical pharmacology : advances and applications · 2025Review
- Candent issues in pneumonia. Reflections from the Fifth Annual Meeting of Spanish Experts 2023.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Review
- Oral versus intravenous antibiotic treatment of moderate-to-severe community-acquired pneumonia: a propensity score matched study.Scientific reports · 2024Observational
- Acceptance of pharmacist-led stewardship recommendations for patients with community-acquired pneumonia.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic Policy.Antibiotics (Basel, Switzerland) · 2023Article
- Article
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundCommunity-acquired pneumonia (CAP) is a leading cause of hospital admissions and antimicrobial use. Clinical practice guidelines recommend switching from intravenous (IV) to oral antibiotics once patients are clinically stable.
methodsWe conducted a retrospective cohort study of adults admitted with CAP and initially treated with IV antibiotics at 642 US hospitals from 2010 through 2015. Switching was defined as discontinuation of IV and initiation of oral antibiotics without interrupting therapy. Patients switched by hospital day 3 were considered early switchers. We compared length of stay (LOS), in-hospital 14-day mortality, late deterioration (intensive care unit [ICU] transfer), and hospital costs between early switchers and others, controlling for hospital characteristics, patient demographics, comorbidities, initial treatments, and predicted mortality.
resultsOf 378 041 CAP patients, 21 784 (6%) were switched early, most frequently to fluoroquinolones. Patients switched early had fewer days on IV antibiotics, shorter duration of inpatient antibiotic treatment, shorter LOS, and lower hospitalization costs, but no significant excesses in 14-day in-hospital mortality or late ICU admission. Patients at a higher mortality risk were less likely to be switched. However, even in hospitals with relatively high switch rates, <15% of very low-risk patients were switched early.
conclusionsAlthough early switching was not associated with worse outcomes and was associated with shorter LOS and fewer days on antibiotics, it occurred infrequently. Even in hospitals with high switch rates, <15% of very low-risk patients were switched early. Our findings suggest that many more patients could be switched early without compromising outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.