Antibiotic treatment outcomes in community-acquired pneumonia

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 communityacquired 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.

Withdrawn: Treatment Failure and Empiric Antibiotic Choice for Hospitalized Patients With Community-Acquired Pneumonia: Β-Lactam/Β-Lactamase Inhibitor Combined With Macrolid or Fluoroquinolone Alone?

“…Menendez et al has reported leucopenia as a predictive factor for TF [5]. Higher leucocytosis is defined as a predictive for TF [17,21]. Gündüz et al's study found no difference in CRP levels at admission between TF and TS groups [13].…”

“…Gündüz et al's study found no difference in CRP levels at admission between TF and TS groups [13]. In contrast, higher CRP levels are shown to be as a demonstrator of deterioration with CAP in more severe and more risky patients [21,22]. Higher PSI score has been found to be the only significant parameter in the multicenter study of Gunduz et al [13].…”

The relationship between neutrophil-lymphocyte ratio and antibiotic therapy in patients with fever of unknown origin

“…20 Similarly, in our study, NLR was found higher in IRFG, 21,22 In several studies, no signifi cant diff erence was observed between the use of macrolides, beta lactam antibiotics and fl uoroquinolones in the antibiotic regimen in CAP patients. 23 In our study, moxifl oxacin antibiotics that belong to fl uoroquinolone are detected to be widely used in pneumonia.…”

Pharmacotherapy and other aspects of senior medical students’ knowledge in community-acquired pneumonia: the final results of the KNOCAP II project

“…The following answers were proposed: the use of ampicillin/ oxacillin (Ampiox); the use of ciprofloxacin; the use of cefazolin; the use of ampicillin per os; the use of respiratory fluoroquinolones in patients without risk factors and a "not sure" option. According to the clinical guidelines (Chuchalin et al 2010), all the options referred to an erroneous strategy in managing non-severe CAP patients: the use of ampicillin per os is accompanied by low bioavailability (40.0%) in comparison with amoxicillin (75-93.0%); cefazolin has a low activity against pneumococci, as well as the absence of clinically significant activity against H. influenzae; ciprofloxacin is low-active against S. pneumoniae and M. pneumonia; it is inappropriate to prescribe respiratory fluoroquinolones as drugs to patients without risk factors; ampicillin/oxacillin (Ampiox) should not be used in medical practice because of an irrational combination of antibiotics (Çilli et al 2018;Cillóniz et al 2018). The majority of students gave an incomplete correct answer -90.5%, fewer than 1.0% of the respondents were able to give the correct answer, and 9.3% of the respondents gave a wrong answer.…”