Vol.57 No.5 September 2009

Efficacy of switch therapy in community-acquired pneumonia in Japan

Katsunori Yanagihara^1,2), Yoshitomo Morinaga^1,2), Koichi Yamada^1,2), Shigeki Nakamura¹⁾, Shintaro Kurihara¹⁾, Kazuko Yamamoto¹⁾, Yoshifumi Imamura¹⁾, Koichi Izumikawa¹⁾, Masafumi Seki¹⁾, Hiroshi Kakeya¹⁾, Yoshihiro Yamamoto¹⁾, Shimeru Kamihira²⁾ and Shigeru Kohno¹⁾

¹⁾Second Department of Internal Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan
²⁾Department of Laboratory Medicine, Nagasaki University Hospital

Abstract

We conducted a prospective randomized controlled study of 69 hospitalized patients to evaluate the efficacy of switch therapy for community-acquired pneumonia corresponding to Fine's risk classes II to IV. All initially underwent intravenous antimicrobial administration for three days. Of the 69, 38 assigned a "switched therapy" changed from injected to oral medication and 31 to a "nonswitched" therapy (NST) group treated by injection alone. Criteria for switching therapy: (1) Improved respiratory symptoms, including cough and dyspnea, (2) CRP <15 mg/dL, (3) Adequately improved oral intake, and (4) BT <38°C for at least 12 h. No statistically significant difference was seen in therapeutic effect between groups -ST: 100% vs. -NST: 96.8%. Results indicated that switching therapy from injection to oral medication, was one more cost effective in treating community-acquired pneumonia.

Key word

community-acquired pneumonia, switch therapy, cost effectiveness, CRP

Received

April 24, 2009

Accepted

July 26, 2009

Jpn. J. Chemother. 57 (5): 423-429, 2009