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To the Editor: Dr Halm and colleagues¹ assessed the point of stabilization of clinical signs and symptoms of pneumonia as patients recover. However, the critical issue is whether a patient who is being treated for community-acquired pneumonia (CAP) needs to have full resolution of these signs of infection prior to changing to oral antibiotic therapy. To my knowledge, no study has proven that intravenous (IV) therapy is critical to patients' recovery from pneumonia if patients are able to take oral medications.

In our study of CAP in 75 hospitalized veterans, we randomized patients to 2, 5, or 10 days of IV antibiotics, and all patients completed 10 days of antibiotic therapy with IV cefuroxime or oral cefuroxime axetil.² Only patients who remained febrile or experienced clinical deterioration were not changed to oral therapy. No difference in outcomes was observed. As long as the patient can swallow and absorb oral antibiotics, . . . [Full Text of this Article]

RELATED ARTICLE

Time to Clinical Stability in Patients Hospitalized With Community-Acquired Pneumonia: Implications for Practice Guidelines
Ethan A. Halm, Michael J. Fine, Thomas J. Marrie, Christopher M. Coley, Wishwa N. Kapoor, D. Scott Obrosky, and Daniel E. Singer
JAMA. 1998;279(18):1452-1457.
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