Sequential therapy in the hospital management of lower respiratory infections

Conventional treatment for patients hospitalized with lower respiratory infections, such as pneumonia or bronchitis, typically consists of parenteral antibiotic therapy for 7–10 days. The clinical evidence, however, shows that in most patients the objective and subjective indicators of infection are substantially improved within the first 2 days of treatment. Thus, many of these patients can be switched to oral antibiotics after 2–3 days of parenteral therapy, with no loss in efficacy of treatment and with substantial savings in terms of cost of care and length of hospital stay. β-Lactam antibiotics are a frequent choice for the oral component following short-term intravenous therapy. The results of recent, large-scale comparative clinical trials support the usefulness of this treatment approach, known as sequential therapy.