TY  - JOUR
T1  - EFfect of macrolides as part of initial empiric therapy on length of stay in patients hospitalized with community-acquired pneumonia
AU  - Stahl JE, Barza M, DesJardin J, Martin R, Eckman MH
Y1  - 1999/11/22
N1  - 10.1001/archinte.159.21.2576
JO  - Archives of Internal Medicine
SP  - 2576
EP  - 2580
VL  - 159
IS  - 21
N2  - Background 
    The choice of antibiotics to treat community-acquired pneumonia (CAP) is primarily empiric, and the effect of this choice on length of stay (LOS) and mortality is largely unknown.Objective 
    To examine the impact of antibiotic choice on these outcomes in general medical patients hospitalized with CAP.Methods 
    One hundred patients hospitalized with CAP were prospectively identified. Seventy-six met inclusion criteria and were entered into the study. After hospital discharge, each medical chart was examined by 2 independent physicians who verified the admitting diagnosis and entered the data for antimicrobial regimens, a CAP mortality prediction tool, a social and disposition index, and other health outcomes. Patients were stratified according to the antibiotic received. Simple regression techniques were used to examine the correlation between initial therapy, specifically, ceftriaxone sodium or a macrolide, and LOS and mortality.Results 
    Patients who received macrolides within the first 24 hours of admission had a markedly shorter LOS (2.8 days) than those not so treated (5.3 days; P=.01). This effect diminished as the interval before administering macrolides increased. Including ceftriaxone as part of the initial therapy did not appear to affect LOS. Patients given a macrolide for initial treatment did not differ significantly from those not treated in terms of mean age, mortality prediction tool score, or Social and Disposition Index score. Eleven of the 12 patients who received macrolides also received a β-lactam antibiotic.Conclusion 
    Use of macrolides as part of an initial therapeutic regimen appears to be associated with shorter LOS.
SN  - 0003-9926
M3  - doi: 10.1001/archinte.159.21.2576
UR  - http://dx.doi.org/10.1001/archinte.159.21.2576
ER  -