Fluoroquinolone-Associated Length of Stay Reduction in the Hospital Treatment of Community-Acquired Pneumonia

Abstract

Hospitalized cases of community-acquired pneumonia (CAP) were reviewed to determine the outcome of changing the empiric first-line therapy for CAP from ceftriaxone ± azithromycin to gatifloxacin. A 27-month period was evaluated. Seven hundred ninety-six cases were identified; 326 preempiric (period 1) and 470 postempiric antibiotic change (period 2). In period 2, 264 patients received gatifloxacin as a component of their antibiotic therapy and 123 received gatifloxacin as the sole antibiotic. Length of stay (LOS) was 4.87 days for patients receiving gatifloxacin-containing regimens and 3.82 days for those treated with gatifloxacin-monotherapy, compared with 5.54 days for non-gatifloxacin-treated cases ( p < 0.0001). These reductions in LOS equate to a cost savings of $120,278 to $143,860 for the institution. Total hospital charges, pharmacy charges and antibiotic costs were also significantly reduced in period 2. The first dose of gatifloxacin was administered 1.54 hours earlier than nongatifloxacin regimens ( p = 0.001). Newer fluoroquinolones offer significant cost reductions and LOS advantages over nonfluoroquinolone regimens in the treatment of CAP. (Infect Dis Clin Pract 2002;11:540-549)

The complications after lung transplantation

“…Diagnóza PCP může být stanovena jedině na základě průkazu mikroorganizmu v plicním sekretu nebo přímo v plicní tkáni. Výtěžnost rutinního sputa je všeobecně nízká [49]. U vyšetření indukovaného sputa je popiso vána senzitivita 55 % a specificita 98 % [50].…”