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Minerva Pneumologica 2003 March;42(1):13-24

language: English, Italian

The evolution of the management of antibiotic therapy in patients with infectious diseases

Sabbatani S., Cesari R.


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Aim. The aim of this study is to describe, in patients admitted for infections, the evolution of clinical management brought about by shift therapy and evaluate the efficiency of treatments.
Methods. Retrospective analysis on 518 patients treated with antibiotics in the 1st semester of 1999 (187 cases), 2000 (190 cases) and 2001 (141 cases). We evaluated prescribed daily dose (PDD), average hospitalisation period (AHP) and average therapy period (ATP) for each drug, qualifying its role in relation to cost and quantity of drugs administered, using Pareto curves. We also calculated total therapy costs and average cost for antibiotic.
Results. In the 3 years, the most used drugs were ceftriaxone and ciprofloxacin; levofloxacin, introduced in 2001, allowed for shorter ATP's. The patients dismissed beforehand in 2000 were 75/190 (39.5%), in 2001 60/121 (49.6%). In 2001, the differences between the usage of shift therapy (ST) in community acquired pneumoniae (CAP) and in all other pathologies, taken as a whole, is highly significant (p<0.001). For ST, the therapy continued at home in 2000 in 19 cases with ciprofloxacin, 7 with ceftriaxone and 7 with cotrimoxazole, and in 2001, in 26 cases with ceftriaxone, 24 with ciprofloxacin (pills) and 11 with levofloxacin (pills).
Conclusion. ST is possible in patients admitted for infection both through oral administration and injections, depending on each case. Our strategy allowed us to significant savings both for drug expenses and hospitalisation time.

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