This is a retrospective study of 340 hospitals looking at non-ICU patients with community acquired pneumonia from 2007-2010 given levofloxacin or moxifloxacin either IV or PO, and testing the magically dogmatic theory that intravenous antibiotics were somehow magically better than their equivalent PO counterpart.
In a triumphant victory for the less is more crowd, patients receiving PO meds had lower rates of antibiotic escalation, but, most importantly, no difference in mortality, length of stay, cost, vasopressor usage, mechanical ventilation, or ICU admission.
So on one hand, it does not seem to make much difference, so just give them an IV dose. On the other, why let the you could look at the growing mount of data that suggests less LoS when PO given over IV as previously documented on this blog, not to mention cost to the patient and institution…
(oh, and if you’re wondering, insurance will still pay even if you give PO antibiotics according to this InterQual update… so you can debunk that argument too.)