Identification of Low-Risk Hospitalized Patients With Pneumonia: Conclusion
Our study has several limitations. Because patients were enrolled in our study retrospectively, the observation that a patient did not suffer a complication while receiving parenteral antimicrobial therapy does not ensure that patient outcomes would not have been compromised had a patient been switched to oral antimicrobial therapy as recommended by the guideline. However, studies published decades ago and more recent studies have documented that carefully selected patients treated with oral antimicrobial therapy have comparable outcomes to patients treated with parenteral antimicrobial therapy, perhaps because of the improved bioavailability and antibacterial spectrum of these agents. Another limitation of this study was that there was a fair amount of disagreement between the physicians judging the relative benefits of parenteral antimicrobial therapy as compared with early conversion to oral antimicrobial therapy in the relatively few low-risk patients who suffered complications during their hospital stay. Finally, the development of a practice guideline does not necessarily mean that it will be used by physicians in clinical practice,” especially since investigators began calling for guidelines for pneumonia patients almost one decade ago and at the present time, no guidelines are in widespread use. The eventual impact of the guideline reported in our present study can only be determined after it has been tested in a prospective clinical trial.
Practice guidelines hold the promise of reducing healthcare costs and improving quality of care. Canadian neighbor pharmacy further Many different organizations have actively promoted or are developing guidelines to control escalating healthcare costs, to reduce undesirable variations in care, and to improve quality of care. However, many guidelines are based on “expert” opinion and may not be strongly supported by clinical data. Although retrospectively derived data cannot substitute for randomized clinical trials, pretesting the safety and effectiveness of a guideline that promotes earlier hospital discharge (as was done in our study) may facilitate acceptance of the guideline. As is the case with introducing a new drug into clinical practice, practice guidelines only should be introduced into patient care after supporting evidence is available. Studies such as ours provide that first layer of evidence about the potential benefits and risks of a practice guideline.
In conclusion, some hospitalized patients who have pneumonia may be suitable for early conversion from parenteral to oral antimicrobial therapy, and some of these patients may be safely discharged from the hospital after 4 days. The explicitly defined guideline described in our study identifies those patients potentially suitable for early conversion therapy. If this guideline is validated in a prospective trial, which will be required before it can be recommended for widespread use, it could be used to reduce healthcare costs while maintaining excellent patient outcomes. Furthermore, this study demonstrates the potential benefit of guidelines derived from clinical information for controlling healthcare costs, improving quality of care, and allocating healthcare resources more appropriately.
Category: Respiratory Symptoms
Tags: antimicrobial therapy, congestive heart failure, healthcare costs, hospitalization, pneumonia