title: Oral versus intravenous antibiotics for community acquired lower respiratory tract infection in a general hospital: open, randomised controlled trial.
abstract: OBJECTIVE
  To see whether there is a difference in outcome between patients treated with oral and intravenous antibiotics for lower respiratory tract infection.
  
  
  METHODS
  Open controlled trial in patients admitted consecutively and randomised to treatment with either oral co-amoxiclav, intravenous followed by oral co-amoxiclav, or intravenous followed by oral cephalosporins.
  
  
  METHODS
  Large general hospital in Dublin.
  
  
  METHODS
  541 patients admitted for lower respiratory tract infection during one year. Patients represented 87% of admissions with the diagnosis and excluded those who were immunocompromised and patients with severe life threatening infection.
  
  
  METHODS
  Cure, partial cure, extended antibiotic treatment, change of antibiotic, death, and cost and duration of hospital stay.
  
  
  RESULTS
  There were no significant differences between the groups in clinical outcome or mortality (6%). However, patients randomised to oral co-amoxiclav had a significantly shorter hospital stay than the two groups given intravenous antibiotic (median 6 v 7 and 9 days respectively). In addition, oral antibiotics were cheaper, easier to administer, and if used routinely in the 800 or so patients admitted annually would lead to savings of around 176,000 pounds a year.
  
  
  CONCLUSIONS
  Oral antibiotics in community acquired lower respiratory tract infection are at least as efficacious as intraveous therapy. Their use reduces labour and equipment costs and may lead to earlier discharge from hospital.
authors.affiliation: Department of Therapeutics, Trinity Centre for Health Science, St James's Hospital, Dublin.
authors.forename: R
authors.initials: R
authors.lastname: Chan
authors.forename: L
authors.initials: L
authors.lastname: Hemeryck
authors.forename: M
authors.initials: M
authors.lastname: O'Regan
authors.forename: L
authors.initials: L
authors.lastname: Clancy
authors.forename: J
authors.initials: J
authors.lastname: Feely
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000191:economics; D019980:Amoxicillin-Potassium Clavulanate Combination; D002969:Clavulanic Acids / Q000008:administration & dosage / Q000191:economics; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000191:economics; D016527:Drug Costs; D004359:Drug Therapy, Combination / Q000008:administration & dosage* / Q000191:economics; D005260:Female; D017721:Hospital Costs; D006769:Hospitals, General; D006801:Humans; D007262:Infusions, Intravenous; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000191:economics; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D002969:Clavulanic Acids; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin