Switch therapy from intravenous to oral cephalosporins in community acquired pneumonia

Background: Many hospitalized patients with community acquired pneumoniae c an be switched early in the course of therapy from intravenous to oral anti biotics, when there are subjective and objective indicators of improvement. This modality of treatment is called "switch therapy". Aim: To compare seq uential therapy using an oral third generation cephalosporin, with conventi onal therapy using intravenous ceftriazone in community acquired pneumonia. Patients and methods: Forty patients admitted due to community acquired pn eumonia. initially treated with ceftriazone 1 g/day iv and that showed clin ical improvement after three days of therapy, were studied. They were rando mly assigned to continue intravenous therapy with ceftriazone for a total o f 10 days or switched to ceftibuten 400 mg od for seven days. Results: Twen ty one patients continued iv treatment and 19 were switched to ceftibuten. There were no differences between both groups in terms of clinical cure, ra diological improvement or normalisation of white blood cell count. Conclusi ons: Patients with community acquired pneumonia that have a good initial re sponse to intravenous antimicrobials, can be safely switched to oral therap y. This therapy will shorten hospital stay and thereby treatment costs.