Prospective study of lower XXXX in an extended-care nursing home program: potential role of oral @entity2177 .

@entity5503 @entity1 @entity3617 @entity55 @entity2177 @entity281 @entity1729 @entity328
PURPOSE: Infections of the lower respiratory tract pose an important problem in nursing homes. Despite the magnitude of this problem, few, if any, antibiotic studies have been targeted specifically at nursing home-acquired @entity281 . Following the establishment of a teaching Extended-Care Nursing Home Program, which facilitated the early diagnosis and therapy of @entity281 , a comparative trial of oral @entity2177 and intramuscular @entity5503 was initiated in elderly @entity1 with lower @entity1729 . In addition to assessing the relative efficacy and safety of @entity2177 and @entity5503 , our goals were to identify problems and pitfalls associated with conducting clinical research in this nursing home setting, evaluate selected clinical and laboratory features of lower respiratory tract @entity281 in this @entity1 population, and measure outcomes in all study groups. @entity1 AND METHODS: During a 20-month period, 40 @entity1 with @entity55 and 20 @entity1 with acute @entity3617 were enrolled in this randomized study. Sixty-three @entity1 with @entity55 who were ineligible for the randomized study were also followed prospectively. The mean age of the 111 @entity1 (123 cases) was 80.8 years; all @entity1 had at least one chronic medical condition. RESULTS: Although @entity328 was the single most common isolate, gram-negative bacteria were cultured from 81 percent of the cases that yielded pathogens from a satisfactory sputum specimen. The in-hospital mortality rate was strikingly low (6.5 percent), and a large majority of @entity1 in all study groups were discharged safely back to their nursing homes well within the Diagnosis-Related Group length of stay. CONCLUSION: @entity2177 appeared to be as safe and effective as @entity5503 in this nursing home program; however, additional studies are needed to determine its role in the treatment of elderly @entity1 with @entity281 .
