Background Current recommendations for the management of pneumonia promote two important measures to optimise antibiotic treatment: start sequential treatment early and do not extend antibiotic treatment more than five days in community-acquired pneumonia and eight days in pneumonia related to healthcare.
Purpose To analyse the duration of levofloxacin and moxifloxacin treatment in pneumonia and to evaluate the use of sequential treatment.
Materials and methods A cross-sectional observational study was performed including all patients admitted for pneumonia to the Pneumology Service of a tertiary hospital, between February–April 2013. The electronic prescribing program was used to identify all patients who started treatment with levofloxacin and moxifloxacin. The diagnosis was confirmed by consulting the electronic medical history. The following variables were analysed: length of treatment in hospital, sequential treatment performed, duration of IV treatment, discharge of patients who had antibiotic treatment and full duration of treatment.
Results The total number of patients included in the study was 100. 13 started oral treatment directly with intrahospital treatment lasting 3.92 days. 87 started with IV treatment (82.76% levofloxacin and 17.24% moxifloxacin). 57.47% (50/87) received sequential treatment, with a mean duration of intravenous treatment of 4.04 days. 36 received only inpatient intravenous treatment, with an average duration of 5.67 days. 59% (59/100) patients continued antibiotic treatment at discharge, the calculated mean overall duration being 11.28 and median of 12 days. 41% (41/100) did not maintain antibiotic treatment at discharge, with the average duration of 7.76 days and median of 5.
Conclusions Sequential treatment shows a high rate of use of fluoroquinolone in the treatment of pneumonia with an average duration of IV treatment of 4 days. Although the number of patients receiving only IV treatment in hospital can be considered high the duration was less than six days. The factor that contributes to the diversion from current recommendations is the maintenance of antibiotic treatment at discharge, which increased the duration up to 12 days.
No conflict of interest.
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