Can enteral antibiotics be used to treat @entity55 in the XXXX ? A clinical outcomes and cost comparison.

@entity1 @entity2028 @entity55 @entity954
BACKGROUND: Controlling healthcare costs without compromising @entity1 care is a focus given recent healthcare changes in the United States. The purpose of this study was to assess clinical improvement in @entity954 ( @entity954 ) @entity1 initiated on or transitioned to enteral antibiotics compared to those who solely receive intravenous (IV) antibiotic therapy for treatment of @entity2028 . MATERIALS AND METHODS: This retrospective cohort study included @entity1 with a positive quantitative respiratory culture being treated for @entity2028 in a @entity954 from 1/1/09 to 3/31/11. Two distinct @entity1 groups were identified: Those treated with IV antibiotics exclusively (IV) and those either initiated on or transitioned to enteral antibiotics within 4 days of antibiotic initiation (PO). The primary endpoint of clinical improvement was assessed on day of antibiotic discontinuation. RESULTS: A total of 647 @entity1 were evaluated; 124 met inclusion criteria (30 @entity1 PO group and 94 IV group). There was no difference in clinical improvement (86.7 PO vs 72.3% IV, P = 0.14) or recurrence (10 PO vs. 12.8% IV, P > 0.99) between groups. Secondary outcomes of duration of mechanical ventilation, ICU and hospital length of stay, and all-cause mortality were also similar. Antibiotic and infection-related costs were significantly decreased in the PO group ( 1,042 vs  697, P = 0.04;  20,776 vs  17,381, P = 0.012, respectively). CONCLUSIONS: @entity954 @entity1 initiated on or transitioned to PO antibiotics for @entity55 had similar clinical outcomes, but significantly less infection-related and antibiotic costs compared to those receiving IV therapy. Further, prospective studies are warranted.
