PURPOSE: We sought to determine the safety, efficacy, and cost of oral therapy for @entity1 with @entity497 . In @entity1 with nonsevere @entity55 , conventional (parenteral) treatment was compared with the oral route; in @entity1 with severe @entity55 , conventional treatment was compared with early switch from parenteral to oral therapy. SUBJECTS AND METHODS: We randomly assigned 85 hospitalized @entity1 with nonsevere @entity55 to one of two groups: 41 received oral antimicrobials from admission, and 44 received parenteral antimicrobials until they had been afebrile for 72 hours before switching to oral treatment. We randomly assigned 103 @entity1 with severe @entity55 who had initially been treated with parenteral antimicrobials to one of two groups: 48 were switched to oral therapy after 48 hours of treatment (early switch), and 55 received a full 10-day course of parenteral antibiotics. RESULTS: Among @entity1 with nonsevere @entity55 , there were no deaths in the oral treatment group, and one @entity204 (2%) in the parenteral treatment group (95% confidence interval [CI] for between-group [oral minus parenteral] difference: -7% to 2%, P = 0.3). The time to resolution of morbidity was < or =5 days in 34 (83%) @entity1 in the oral treatment group and 39 (88%) @entity1 in the parenteral treatment group (P = 0.5); there were treatment failures in 4 (10%) @entity1 in the oral treatment group and 14 (32%) @entity1 in the parenteral treatment group (P = 0.02). Among @entity1 with severe @entity55 , there was one (2%) @entity204 in the early-switch group and no deaths in the full course of parenteral antibiotics groups (95% CI for between-group [early switch vs. full course] difference: -2% to 6%, P = 0.5). The time to resolution of morbidity was < or =5 days in 38 (79%) @entity1 in the early-switch group and 41 (75%) in the full-course group (P = 0.3). There were 12 (25%) treatment failures in the early-switch group and 13 (24%) in the full-course group (P = 0.9). There were fewer adverse events in the oral and early-switch groups, primarily due to lower rates of infusion-related @entity3527 . Significant cost savings, mainly due to a shorter hospitalization, occurred among @entity1 with severe @entity55 in the early-switch group. CONCLUSION: Inpatients with nonsevere @entity497 can be effectively and safely treated with oral antimicrobials from the time of admission, whereas those with severe @entity55 can be treated with early-switch therapy.

Efficacy and safety of oral and early-switch therapy for XXXX : a randomized controlled trial.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity497 :: ('MESH:D003147', 'Disease') :: ['community-acquired pneumonia'] @entity3527 :: ('MESH:D010689', 'Disease') :: ['phlebitis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity497 :: (MESH:D003147,Disease) :: ['community-acquired pneumonia']
