Clinical and economic evaluation of oral ciprofloxacin after an abbreviated course of intravenous antibiotics
Article Abstract:
Patients who develop serious infections are typically hospitalized and treated intravenously with antibiotics for 7 to 10 days. The length of treatment is usually arbitrarily chosen, or used according to custom. Some investigators have questioned if a shorter period of intravenous therapy followed by oral agents can not be equally effective. Ciprofloxacin is one of a group of powerful antibiotics that are effective against a wide variety of bacteria. It may be possible to replace some intravenous antibiotic therapy with oral ciprofloxacin. The results of treatment with oral ciprofloxacin for at least five days after three days of intravenous antibiotics in 52 patients (IV group) was compared with the results of intravenous antibiotic therapy continued for at least eight days in 53 patients. The average duration of intravenous therapy in the IV group was 20 days, while patients in the ciprofloxacin group were treated with antibiotics for an average of 22 days. After the three initial days of intravenous treatment, bacteria were absent in 57 percent of the IV samples and 64 percent of the ciprofloxacin group samples. The infection-causing bacteria were gone in 76 percent of the IV group and 89 percent of the other group, an insignificant difference. Infections recurred in two patients in each group. The failure rate was significantly greater in the IV group. Ciprofloxacin enabled early discharge of some patients, leading to significant cost savings. The frequency of adverse effects of treatment was similar in both groups. This report indicates that oral ciprofloxacin, used after three days of intravenous antibiotic therapy, is as safe and effective as a full course of intravenous therapy and is more cost effective. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Chlamydia pneumoniae pneumonia with pleural effusion: diagnosis by culture
Article Abstract:
The case report is presented of a 19-year-old man who developed malaise, severe chest pain, a cough, and weight loss. The patient had been taking an antibiotic (cephalexin) for seven days without relief, and shortness of breath had developed. A different antibiotic (erythromycin) was prescribed, but it caused gastrointestinal discomfort and the patient stopped taking it. After admission to the hospital, the patient's respiratory symptoms worsened and treatment with intravenous erythromycin was started. X-ray studies showed lung abnormalities. A pleural effusion (presence of fluid in the pleural space, between the layers of membrane that surround the lungs) was detected and aspirated. This brought prompt relief of symptoms. Examination of swab specimens from the patient's throat and of the pleural fluid showed that the bacteria Chlamydia pneumoniae was present. This agent can cause a mild to moderately severe pneumonia, often with sore throat, in healthy young adults. It can also affect older people, requiring hospitalization. This represents the first reported case in which C. pneumoniae has been isolated from pleural fluid. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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