Christina Sebrian
Oral therapy instead of intravenous antibacterial therapy, the so-called ” sequential therapyimplying a paradigm shift in approach community pneumonia. Several international studies have shown that this therapy improves patients’ quality of life by reducing hospital admissions.
This is one of the benefits highlighted by the program Dr. Jose BarberanInternist, Royal Hospital Monte Principe, University of Madrid Camilo José Serra, Professor, Department of Health Sciences, Royal Hospital Sequential treatment of community-acquired pneumoniawithin this framework The 5th Pneumonia Dayorganized by the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc) Critical Patient Infection Research Group, in collaboration with laboratories such as Meiji.
Sequential therapy reduces risk of bloodstream and catheter-related infections and reduces medical device costs
Another advantage of sequential therapy is that “It does not have a negative impact on mortality or recurrence of infection. Additionally, ICU admissions decreased and hemodynamics stabilized.“, assured Dr. Barberin. Or, the physician recalled, Reduce the risk of blood infections and catheter-related infections, and reduce medical equipment costs and care time.On the other hand, he emphasized Potential carbon footprint reduction“an important aspect of the times in which we live“.
This alternative to the ‘ideal’ antibiotic
main Sequential treatment requirements The patient’s clinical condition is stable. That is to say, now “Sufficient heart and respiratory rates, no fever, adequate saturation, and the patient can eat and drink to establish oral therapy” explained Dr. Barberin.
When implemented, different medications can be used Alternative antibiotics for intravenous therapy. Experts clarify that drugs should be used “Antimicrobial spectrum similar to that of the replaced one, high bioavailability, little selection of resistant mutants, if possible, low cost“.
Dr. José Barberán: “Doctors are not aware that this therapy exists. We should be aware of the benefits that this treatment strategy can bring”
In this sense, Dr. Barberán mentioned that oral amoxicillin-clavulanic acid (PO) replaces intravenous (IV) amoxicillin-clavulanic acid; cefditoren PO replaces intravenous ceftriaxone, and levofloxacin PO replaces intravenous Levofloxacin. Regarding the use of the antibiotic ceftitorin PO, the physician commented: “Given its low minimum inhibitory concentration (MIC) against the vast majority of pneumococcal strains, a dose of 400 mg every 12 hours would have no problem achieving the goal of exceeding 40% of the interval between two consecutive doses.
Barriers to Sequential Treatment Implementation
this international clinical practice guidelines Sequential therapy is recommended. In Spain, however, the bill has not yet been fully implemented. The reason, says Dr. Barberán, is that “Doctors didn’t know this treatment existed“. Therefore, he insisted that “We should be aware of the benefits this treatment strategy can bring.“.
For this you also need Establishing a sequential treatment plan in the hospital. “Pneumonia patients must be identified and tracked, feedback must be provided among experts, and patients must be monitored to measure interventions and understand the positive impact of this therapy.We should implement these systems and institutionalize them in hospitals”, concluded the physician.