Duration of intravenous therapy and hospital stay according to choice of empirical antimicrobial treatment for community-acquired respiratory infection

A review of patients admitted to medical wards with respiratory infection w as undertaken to look for differences in duration of intravenous (IV) thera py and length of patient stay based on the class of IV antimicrobial used i n treatment. Data was analysed from 231 patients with community-acquired re spiratory infection who were treated empirically for at least 24 h with eit her an IV cephalosporin (146 patients) or an IV penicillin or macrolide (85 patients). The severity of illness and indication for IV treatment was sim ilar in each group. Those treated with a cephalosporin received IV therapy for a significantly longer period (mean = 4.44 days, SD = 2.6) than those g iven a penicillin or macrolide (mean = 3.3 days, SD = 1.8): P < 0.001. Pati ent stay was significantly longer in the cephalosporin group (mean = 11.6 d ays, SD = 10.4) than the penicillin/macrolide group (mean = 9.4 days, SD = 6.3): P = 0.04. These differences are most readily accounted for by the abs ence from the hospital formulary of a third generation oral cephalosporin, a drug that might be regarded as an obvious form of follow-on therapy in pa tients treated empirically with an injectable cephalosporin. (C) 1999 Elsev ier Science B.V. and International Society of Chemotherapy. All rights rese rved.