Clinical and microbiological features of native vertebral osteomyelitis (NVO) in adults: a retrospective analysis from a private hospital of Mendoza, Argentina

Abstract

therapy that includes a beta-lactam plus a macrolide; however, the evidence from controlled trials does not confirm this observation.To assess the impact of monotherapy with a beta-lactam versus beta-lactam plus a macrolide on 14-day mortality in patients hospitalized with CAP.Methods & Materials: NACREG1 is a prospective populationbased study conducted in three cities of South America designed to estimate incidence rate of CAP in adults. Patients ≥18 years of age with radiographically confirmed diagnosis of CAP were enrolled. This substudy analyzes 14-day mortality according to the initial antibiotic regimen in hospitalized patients. The antibiotic regimen was chosen by the attending physician, the choice of which was not part of the NACREG1 study. Initial antibiotic regimens were grouped as monotherapy with beta-lactam antibiotics (MB), combined therapy with beta-lactams plus macrolide (BM), and other regimens.Results: From January 2012 to December 2016, 2700 were enrolled in the study, of which 1897 were hospitalized, 1444 in the general ward (76.3%) and 448 in the ICU (23.7%). 956 received MB, 771 BM and 163 other regimens. In the whole population of hospitalized patients 14-day mortality was 16.6% for those on MB and 18% for those on BM (p = 0.52). For patients hospitalized in ICU 14-day mortality was 34,8% for those who received MB and 33% for those treated with BM (p = 0.75). For patients hospitalized in general ward, 14-day mortality in those treated with MB was 13,2% and 11,2% for those treated with BM (p = 0.30). Conclusion:The present study shows that in a real world study, without adjustment for severity or other variables, patients hospitalized with CAP in general ward or in the ICU, 14-day mortality was similar for those who received monotherapy with beta-lactams or combination therapy with beta-lactam plus macrolide.