Switch Therapy with β-Lactam/β-Lactamase Inhibitors in Patients with Community-Acquired Pneumonia

Abstract

BACKGROUND: Antimicrobial drugs are prescribed inappropriately nearly 50% of the time. To address this problem, a hospital antimicrobial team was formed integrating the talents of infectious disease physicians, pharmacists, microbiologists, infectious control practitioners, and nurses. The primary goal of the team is to provide optimal, cost-effective antimicrobial therapy. OBJECTIVE To review the principles of streamlining antimicrobial therapy, with an emphasis on antibiotic switch therapy. DISCUSSION: With appropriate guidelines, switch therapy appears to be an important means to provide optimal antimicrobial therapy complementing the many social pressures placed on patients, while positively impacting on the overall cost of treatment. The use of β-lactam/β-lactamase inhibitor combinations as the antibiotics for initial intravenous medication to oral combination switch therapy is a viable approach to the treatment of hospitalized patients with community-acquired pneumonia. Preliminary data from our institution were obtained with such a therapeutic approach to assess the clinical efficacy, patient satisfaction with their care, and calculated dollar savings in the overall cost of care. The results of this evaluation strongly support the validity and desirability of such an approach. CONCLUSIONS The prospective use of a program that incorporates the use of β-lactam/β-lactamase inhibitor combinations for intravenous and switch-to-oral drug administration is a cost-effective means of providing optimal antimicrobial therapy for patients with community-acquired pneumonia.