Conversion of intravenous to oral/nasogastric antibiotics in critically ill patients with pneumonia
Bibliographic record
Abstract
ABSTRACT BACKGROUND: Considering the fiscal restraints on health care, an intravenous (IV) to oral/nasogastric (PO/NG) conversion program for critically ill patients with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) was developed. OBJECTIVE: Our purpose was to evaluate the feasibility of implementing an IV to PO/NG conversion program in this population and to assess patient outcomes. METHODS: Intensive care unit (ICU) patients diagnosed with CAP and HAP were eligible for enrollment. Patients that met predefined criteria were converted to an enteral regimen. Temperature, white blood cell counts and oxygen requirements were evaluated at baseline, time of conversion and end of oral therapy. Treatment courses were evaluated for clinical and microbiological outcomes. RESULTS: During a 5-month period, 26 ICU patients were entered into this trial (13 CAP and 13 HAP). Mean age (± SD) was 61 (17.3) and 55.8 (20) years old, and mean Acute Physiology and Chronic Health Evaluation II (APACHE II) scores 24 (6.7) and 19 (6.7) in the CAP and HAP groups respectively. Mechanical ventilation was required in 69.2% of patients. Conversion occurred in 77% and 92% of CAP and HAP patients after a mean of 6.6 and 5 days. Twenty patients were clinically evaluable and cure or improvement occurred in all cases. Seventeen patients had positive microbiological cultures and eradication was observed in 13 of these patients (76%). CONCLUSION: An IV to PO/NG conversion program for critically ill patients with CAP or HAP is feasible and effective.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".