Abid Yaqub, Zafar Ullah Khan.
Comparison of early intravenous to oral switch Amoxicillin/Clavulanate with parenteral Ceftriaxone in treatment of hospitalized patients with community acquired pneumonia.
Pak J Med Sci Jan ;21(3):259-66.

Objective: To compare the clinical efficacy and cost effectiveness of early intravenous to oral switch Amoxicillin/Clavulanate and parenteral Ceftriaxone in treatment of hospitalized patients with community acquired pneumonia (CAP). Design: Open, randomized, parallel group comparative study. Setting: Department of Medicine at Services Hospital, Lahore Patients and Methods: Fifty patients with community acquired pneumonia requiring intravenous antibiotics on admission to the hospital and fulfilling study criteria were enrolled and randomly assigned to receive therapy either with Amoxicillin/Clavulanate or Ceftriaxone. Patients in Amoxicillin/Clavulanate group were switched from IV to oral antibiotics based upon switch criteria whereas those in Ceftriaxone group completed the therapy parenterally. Main Outcome Measures: The two groups were compared to each other on the basis of clinical and bacteriological outcome at the end of treatment and follow up. Treatment costs were calculated for the two study groups. Results: The two study groups had equal clinical efficacy, both at the end of treatment and follow up. Mean duration of treatment was equal for both groups (8 days); however mean hospitalization stay was significantly shorter (4.1 day) for Amoxicillin/Clavulanate group as compared to Ceftriaxone group (8.2 days). The cumulative savings for intravenous to oral switch Amoxicillin/Clavulanate was Rs. 1,70,137 or Rs. 7,397 saved per patient. Conclusion: Early intravenous to oral switch Amoxicillin/Clavulanate had comparable clinical efficacy to parenteral Ceftriaxone and resulted in reduced hospitalization stay and decreased treatment costs and is a more cost effective treatment of community- acquired pneumonia patients requiring intravenous antibiotics on admission.

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