title: Intravenous-to-oral transition therapy in community-acquired pneumonia: the INOVA Health System experience.
abstract: Economic pressures on the delivery of health care have necessitated a focus on reducing costs and resource utilization while maintaining or improving the quality of care. A growing consensus holds that switching from intravenous to oral therapy is a cost-effective and clinically sound approach for a significantly large group of patients with community-acquired pneumonia (CAP). Drug utilization studies within the INOVA Health System revealed that levofloxacin is a cost-effective alternative to ciprofloxacin in infectious disease and that use of risk prediction criteria can reduce inappropriate hospitalizations for CAP, thereby reducing costs. In addition, the INOVA experience demonstrates that the strategy used to implement new antibiotic regimens such as switch-therapy regimens is an important factor in cost reduction: a therapeutic interchange mandate is more successful than standard educational techniques in changing treatment patterns.
authors.affiliation: INOVA Health System, Falls Church, Virginia, USA.
authors.forename: G
authors.initials: G
authors.lastname: Milkovich
mesh_terms: D018806:APACHE; D000284:Administration, Oral; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D004363:Drug Utilization / Q000191:economics; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007275:Injections, Intravenous; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D011014:Pneumonia / Q000188:drug therapy* / Q000191:economics; D014768:Virginia
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D064704:Levofloxacin; D015242:Ofloxacin