BMJ. 2016;48(3):797–807.Rodvold KA, Gotfried MH, Danziger LH, et al. There were 118 patients with a compromised oral route that were excluded (all had IV therapy). (2016). You can also search for this author in This observational study used propensity matching to compare two groups of … 2009;64 Suppl 3:iii1–55.Yuan X, Liu Y, Bai C, et al. This manuscript seeks to estimate and compare the costs of treating children hospitalised with community-acquired pneumonia, with oral and intravenous antibiotics, thus determining which treatment is cost minimising. No other differences were observed between oral and IV groups.Conclusion: Where the oral route is not compromised, oral macrolides appear to be equivalent to IV in treating moderate to severe CAP.We use cookies to help provide and enhance our service and tailor content. The time to clinical stability in both cohorts was a median of 5 days (interquartile range 3-7 days, p = 0.3). Eur Respir J. Sample size was determined based on the available data. Take this medication by mouth with or without food as directed by your doctor, usually every … Analysis of a hospitalized UK cohort. BMJ. Oral versus intravenous clarithromycin in moderate to severe community-acquired pneumonia: an observational studyOral versus intravenous clarithromycin in moderate to severe community-acquired pneumonia: an observational studyOral versus intravenous clarithromycin in moderate to severe community-acquired pneumonia: title = "Oral versus intravenous clarithromycin in moderate to severe community-acquired pneumonia: an observational study", abstract = "Objectives: British Thoracic Society guidelines recommend clarithromycin in addition to beta-lactam antibiotics for patients with community-acquired pneumonia and CURB-65 score 2-5. Determinants of outcome in patients with bacteraemic pneumococcal pneumonia: importance of early adequate treatment. Between the treatment groups, outcomes were assessed after multivariable adjustment using Cox proportional hazards regression. Eur Respir J. Nevertheless, it must be noted that none of the hazard ratios suggested a harmful effect of oral therapy.This observational study suggests that route of administration of clarithromycin in patients with moderate or severe CAP is not associated with a difference in clinical outcome, in patients able to take oral therapy. ", keywords = "Macrolide, Pneumonia, Severity, Combination therapy, Antibiotic", author = "Nikolas Rae and Aran Singanayagam and Stuart Schembri and Chalmers, {James D.}", note = "No specific funding was required for this study. N Engl J Med. Clin Infect Dis. Clin Infect Dis. British Thoracic Society guidelines recommend clarithromycin in addition to beta-lactam antibiotics for patients with community-acquired pneumonia and CURB-65 score 2–5. Intravenous therapy is commonly used but there are few data on whether oral therapy is equally effective. 2010;42:185–92.Asadi L, Sligi WI, Eurich DT, et al. Antibiotic treatment strategies for community-acquired pneumonia in adults. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. 2013;1(8):653–62.Chalmers JD, Akram AR, Singanayagam A, Wilcox MH, Hill AT. There were no significant differences in demographics, or physiological or laboratory parameters between the two groups, as shown in Table There were 38 deaths (16.8%) in the IV group and 33 deaths (14.6%) in the oral group (There were 24 patients (10.6%) who were admitted to the ICU >24 h after admission in both groups (Kaplan-Meier plot of 30-day mortality between patients receiving oral or intravenous clarithromycin for moderate to severe community-acquired pneumoniaIn the analysis limited to patients with CURB-65 scores 3–5 (To exclude strong confounding effects from patients excluded from the propensity analysis, we performed a Cox proportional hazard regression including all patients (The addition of an IV macrolide to a β-lactam agent in the treatment of moderate or severe CAP is recommended in national and international guidelines [Macrolides are primarily added to provide cover for atypical pathogens.