title: Comparison between the Efficacy of Switch Therapy and Conventional Therapy in Pediatric Community-Acquired Pneumonia.
abstract: OBJECTIVE
  Compare the treatment outcomes ofswitch therapy and conventional therapy inpediatricpatients aged one month to five years old, diagnosed with community-acquired pneumonia who required hospitalization.
  
  
  METHODS
  The present study was performed and approved by the Siriraj Research Ethics Committee. With informed consent, 57 patients whofitted the inclusion criteria were randomized into two groups, 1) the switch therapy group (SWT), who switched their method of receiving antibiotics from IV to oral within 24 hours after clinical improvement and body temperature under 37.8 °C at least eight hours, and 2) the control group, the group treated as routine general practice. Chi-square tests, Fisher's exact tests, unpaired t-tests, and Mann-Whitney U tests were used in analysis. A non-inferiority analysis to estimate 1-sided 95% CIs was performed to determine the greatest difference (worst case) between groups.
  
  
  RESULTS
  There were no significant differences in age, sex, clinical presentations, and antibiotics provided between the two groups. A statistically significant reduction in length of hospital stay was found in the SWT group (P = 0.019), whereas the readmission rate for both groups was not significantly different (p = 0.66). Morbidity and mortality were not found in either groups. The SWT group demonstrated non-inferior efficacy comparing to control group (difference 20%; p<0. 001).
  
  
  CONCLUSIONS
  In pediatric community-acquired pneumonia, early switching from administer IVantimicrobial agents to oral form when clinical signs improved were safe and effective. Switch therapy showed non-inferiority outcomes compared to conventional therapy, and had advantages in shortening the length ofstay and indirectly lowering the cost of hospitalization.
authors.forename: Supinya
authors.initials: S
authors.lastname: In-iw
authors.forename: Gommigar
authors.initials: G
authors.lastname: Winijkul
authors.forename: Suprapath
authors.initials: S
authors.lastname: Sonjaipanich
authors.forename: Boonying
authors.initials: B
authors.lastname: Manaboriboon
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010865:Pilot Projects; D011014:Pneumonia / Q000188:drug therapy*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013785:Thailand
chemical_list: D000900:Anti-Bacterial Agents