Antibiotic treatment outcomes in community-acquired pneumonia

Turk J Med Sci. 2018 Aug 16;48(4):730-736. doi: 10.3906/sag-1709-144.

Abstract

Background/aim: The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with community- acquired pneumonia in nonintensive care unit (ICU) wards and treated with a β-lactam, β-lactam and macrolide combination, or a fluoroquinolone.

Materials and methods: This prospective cohort study was performed using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey.

Results: Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated bacteria were S. pneumoniae (21.8%) and P. aeruginosa (19.2%). The clinical cure rate and length of stay were not different among patients treated with β-lactam, β-lactam and macrolide combination, and fluoroquinolone. Forty-seven patients (9.2%) died during the hospitalization period. There was no difference in survival among the three treatment groups.

Conclusion: In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between β-lactam, β-lactam and macrolide combination, and fluoroquinolone regimens.

Keywords: Pneumonia; beta-lactam; fluoroquinolone; macrolide.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Community-Acquired Infections / drug therapy*
  • Community-Acquired Infections / microbiology
  • Community-Acquired Infections / mortality
  • Drug Therapy, Combination
  • Female
  • Fluoroquinolones / therapeutic use*
  • Hospital Departments
  • Hospital Mortality
  • Hospitals
  • Humans
  • Length of Stay*
  • Macrolides / therapeutic use*
  • Male
  • Middle Aged
  • Pneumonia / drug therapy*
  • Pneumonia / microbiology
  • Pneumonia / mortality
  • Prospective Studies
  • Pseudomonas aeruginosa / growth & development
  • Streptococcus pneumoniae / growth & development
  • Treatment Outcome
  • Turkey / epidemiology
  • beta-Lactams / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Macrolides
  • beta-Lactams