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To the Editor: Dr Marrie and colleagues¹ concluded that "the implementation of a critical pathway [for treating community-acquired pneumonia in Canada] reduced the institutional resources without causing adverse effects on the well-being of the patients." However, several issues should be evaluated before this recommendation is widely adopted.

First, the average length of stay (LOS) for the institutions using a pathway was 8.2 days, almost 3 days longer than the national average in the United States.² The large difference between the mean and median implies a skewed distribution in the LOS. This calls into question whether some patients were being treated for complications of pneumonia or an unrelated event. On average, patients stayed more than 3 additional days in the hospital after being converted from intravenous antibiotics to oral therapy regardless of type of institution. This is inconsistent with data from the United States, where patients are discharged approximately 1 day . . . [Full Text of this Article]

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