Tags

Type your tag names separated by a space and hit enter

Azithromycin monotherapy for patients hospitalized with community-acquired pneumonia: a 31/2-year experience from a veterans affairs hospital.
Arch Intern Med. 2003 Jul 28; 163(14):1718-26.AI

Abstract

BACKGROUND

Current American Thoracic Society (ATS) community-acquired pneumonia treatment guidelines recommend azithromycin monotherapy for a limited subset of hospitalized patients. We evaluated the effectiveness of azithromycin monotherapy in a more generalized population of patients hospitalized with mild-to-moderate community-acquired pneumonia.

METHODS

We reviewed medical records from a Veterans Affairs facility for patients admitted with community-acquired pneumonia between December 1, 1997, and June 30, 2001, comparing those receiving azithromycin monotherapy, other ATS-recommended antibiotics, and non-ATS-recommended antibiotics. We excluded patients with immunosuppression, metastatic cancer, or hospital-acquired pneumonia. Outcome measures included times to stability, meeting criteria for change to oral therapy, and eligibility for discharge; length of stay; intensive care unit transfer; and mortality. Outcomes were adjusted for pneumonia severity, skilled nursing facility status, and processes of care.

RESULTS

A total of 442 patients were eligible for the study (221 in the azithromycin monotherapy group, 129 in the ATS group, and 92 in the non-ATS group). Times to clinical stability and to fulfilling early switch criteria were not statistically significantly different among the 3 groups. Mean time to fulfilling early discharge criteria was 2.48 days for patients receiving azithromycin monotherapy vs 2.84 days for those receiving ATS antibiotics (P =.008) and 2.58 days for those receiving non-ATS antibiotics (P =.64). Overall mean length of stay was shorter in the azithromycin monotherapy group (4.35 days) vs the ATS (5.73 days) (P =.002) and non-ATS (6.21 days) (P<.001) groups. Mortality, intensive care unit transfer, and readmission rates were similar across the groups.

CONCLUSION

Azithromycin monotherapy is equally as efficacious as other ATS-recommended regimens for treating hospitalized patients with mild-to-moderate community-acquired pneumonia.

Authors+Show Affiliations

Division of Infectious Diseases, the VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Guideline
Journal Article
Multicenter Study
Practice Guideline
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12885688

Citation

Feldman, Randy B., et al. "Azithromycin Monotherapy for Patients Hospitalized With Community-acquired Pneumonia: a 31/2-year Experience From a Veterans Affairs Hospital." Archives of Internal Medicine, vol. 163, no. 14, 2003, pp. 1718-26.
Feldman RB, Rhew DC, Wong JY, et al. Azithromycin monotherapy for patients hospitalized with community-acquired pneumonia: a 31/2-year experience from a veterans affairs hospital. Arch Intern Med. 2003;163(14):1718-26.
Feldman, R. B., Rhew, D. C., Wong, J. Y., Charles, R. A., & Goetz, M. B. (2003). Azithromycin monotherapy for patients hospitalized with community-acquired pneumonia: a 31/2-year experience from a veterans affairs hospital. Archives of Internal Medicine, 163(14), 1718-26.
Feldman RB, et al. Azithromycin Monotherapy for Patients Hospitalized With Community-acquired Pneumonia: a 31/2-year Experience From a Veterans Affairs Hospital. Arch Intern Med. 2003 Jul 28;163(14):1718-26. PubMed PMID: 12885688.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Azithromycin monotherapy for patients hospitalized with community-acquired pneumonia: a 31/2-year experience from a veterans affairs hospital. AU - Feldman,Randy B, AU - Rhew,David C, AU - Wong,John Y, AU - Charles,Robert Antoine, AU - Goetz,Matthew Bidwell, AU - ,, PY - 2003/7/30/pubmed PY - 2003/8/23/medline PY - 2003/7/30/entrez SP - 1718 EP - 26 JF - Archives of internal medicine JO - Arch Intern Med VL - 163 IS - 14 N2 - BACKGROUND: Current American Thoracic Society (ATS) community-acquired pneumonia treatment guidelines recommend azithromycin monotherapy for a limited subset of hospitalized patients. We evaluated the effectiveness of azithromycin monotherapy in a more generalized population of patients hospitalized with mild-to-moderate community-acquired pneumonia. METHODS: We reviewed medical records from a Veterans Affairs facility for patients admitted with community-acquired pneumonia between December 1, 1997, and June 30, 2001, comparing those receiving azithromycin monotherapy, other ATS-recommended antibiotics, and non-ATS-recommended antibiotics. We excluded patients with immunosuppression, metastatic cancer, or hospital-acquired pneumonia. Outcome measures included times to stability, meeting criteria for change to oral therapy, and eligibility for discharge; length of stay; intensive care unit transfer; and mortality. Outcomes were adjusted for pneumonia severity, skilled nursing facility status, and processes of care. RESULTS: A total of 442 patients were eligible for the study (221 in the azithromycin monotherapy group, 129 in the ATS group, and 92 in the non-ATS group). Times to clinical stability and to fulfilling early switch criteria were not statistically significantly different among the 3 groups. Mean time to fulfilling early discharge criteria was 2.48 days for patients receiving azithromycin monotherapy vs 2.84 days for those receiving ATS antibiotics (P =.008) and 2.58 days for those receiving non-ATS antibiotics (P =.64). Overall mean length of stay was shorter in the azithromycin monotherapy group (4.35 days) vs the ATS (5.73 days) (P =.002) and non-ATS (6.21 days) (P<.001) groups. Mortality, intensive care unit transfer, and readmission rates were similar across the groups. CONCLUSION: Azithromycin monotherapy is equally as efficacious as other ATS-recommended regimens for treating hospitalized patients with mild-to-moderate community-acquired pneumonia. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/12885688/Azithromycin_monotherapy_for_patients_hospitalized_with_community_acquired_pneumonia:_a_31/2_year_experience_from_a_veterans_affairs_hospital_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/163/pg/1718 DB - PRIME DP - Unbound Medicine ER -