Effect of Previous Antimicrobial Therapy on Bacteriological Findings in Patients With Primary Pneumonia

Spencer, R. C.; Philp, J. R.

doi:10.1016/s0140-6736(73)93192-9

Cited by 64 publications

(17 citation statements)

References 6 publications

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“…The marked reduction in microbiological diagnostic sensitivity with prior antibiotic treatment is well documented 4,5,[13][14][15] and is perhaps most critical for the culture of S. pneumoniae as 16 significantly fewer (2/79) patients were diagnosed with pneumococcal infection than with other pathogens (18/83) where antibiotic treatment was given before admission.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic treatment and the diagnosis of Streptococcus pneumoniae in lower respiratory tract infections in adults

Korsgaard

Frimodt‐Møller

Kilian

2005

International Journal of Infectious Diseases

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The diagnosis of infection with S. pneumoniae is very dependent on whether or not recent (within 2-4 weeks) or immediate (within 48 hours) antibiotic treatment has been given prior to microbiological sampling of patients. The results suggest an optimized diagnostic strategy with, if possible, sampling for culture prior to antibiotic treatment, while sampling for pneumococcal antigens should wait 24-48 hours for antibiotic treatment.

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Section: Discussionmentioning

confidence: 99%

Antibiotic treatment and the diagnosis of Streptococcus pneumoniae in lower respiratory tract infections in adults

Korsgaard

Frimodt‐Møller

Kilian

2005

International Journal of Infectious Diseases

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“…Twenty-nine (36%) of our cases had no microbial diagnosis compared with 52% from the Bristol study (White et al 1981) where no test was performed for pneumococcal antigen. A previous hospital study (Spencer & Philp 1973) of pneumonia suggested that antibiotic prescribing by general practitioners influenced the number of undiagnosed cases. However, in our study this cannot be the full explanation since only 7 out of 29 undiagnosed cases were taking antibiotics at the time of admission.…”

Section: Discussionmentioning

confidence: 99%

Adult Community-Acquired Pneumonia in Central London

et al. 1984

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Summary: Strep. pneumoniae was diagnosed as the cause of pneumonia in 40 (50%) of 80 consecutive adults admitted to St Stephen's Hospital with community-acquired pneumonia. None of the patients had evidence of Mycoplasma pneumoniae infection, and Legionella pneumophila serology was positive on only one occasion. In 29 patients (36%) no causative organism was demonstrated. The diagnosis of pneumococcal infection was obtained in 15 cases by isolating Strep. pneumoniae from the sputum, in 13 further cases by demonstrating pneumococcal capsular antigen in sputum, and in 12 other cases by detecting pneumococcal antigen in serum only. Only 2 cases with pneumococcal pneumonia were bacteraemic and 3 patients (7%), all aged more than 75 years, died. The relatively low bacteraemic and mortality rates suggest that community-acquired pneumococcal pneumonia currently seen in patients admitted to hospital in central London may not be so severe as in some other areas.

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“…This suggests that if bronchiectasis are excluded, as in our study, these organisms are rarely isolated. Prior antibiotic therapy (25) has been suggested as a predisposing factor for gram-negative pneumonia. In our study, three of these four patients had received prior antibiotic therapy.…”

Section: Treatment Of Pneumoniamentioning

confidence: 99%

Community-acquired pneumonia in chronic obstructive pulmonary disease: a Spanish multicenter study.

Torres

Dorca²,

Zalacaín³

et al. 1996

Am J Respir Crit Care Med

165

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Community-acquired pneumonia (CAP) is an infectious illness that frequently motivates hospital admission when comorbid conditions are present. However, the epidemiology of CAP in relation to the underlying disease of the patients is not well known. We performed a prospective multicenter study with the aim of assessing the clinical characteristics, etiology, and outcome of chronic obstructive pulmonary disease (COPD) patients with CAP. Between October 1992 and December 1994 we studied 124 COPD patients (mean FEV1 40 +/- 11% of predicted, mean FVC/FEV1 49 +/- 10) admitted because of CAP to one of the participating centers. An attempt to obtain an etiologic diagnosis was performed by means of blood cultures (n = 123), sputum cultures (n = 97), pleural fluid cultures (n = 17), protected specimen brush samples (n = 41), percutaneous transthoracic needle aspiration (n = 41), and serology (n = 106). Etiologic diagnosis was achieved in 80 (64%) of cases, however, diagnosis based upon valid techniques was only possible in 73 (59%) cases. The main causal microorganisms were the following: Streptococcus pneumoniae in 32 (43%), Chlamydia pneumoniae in 9 (12%), Hemophilus influenzae in 7 (9%), Legionella pneumophila in 7 (9%), Streptococcus viridans in 3 (4%), Coxiella burnetii in 3 (4%), Mycoplasma pneumoniae in 2 (3%), Nocordia asteroides 2, Aspergillus ssp. 1, and others 10. In three of these cases the etiology was polymicrobial. Bacteremia was present in 19 (15%) cases; S. pneumoniae was the most frequent isolate (13 cases). Antibiotic treatment was modified in 22 cases due to etiologic findings, and in 9 due to therapeutic failure. Ten patients died (8%), and 22 needed mechanical ventilation, the mortality rate in the latter population being 23%. Total or partial resistance of S. pneumoniae to penicillin was observed in 10 of 32 (31%) isolations, and to erythromycin in 2 (6%). The results of this study are important for the standardization of empiric antibiotic strategies in COPD patients with pneumonia.

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Effect of Previous Antimicrobial Therapy on Bacteriological Findings in Patients With Primary Pneumonia

Cited by 64 publications

References 6 publications

Antibiotic treatment and the diagnosis of Streptococcus pneumoniae in lower respiratory tract infections in adults

Antibiotic treatment and the diagnosis of Streptococcus pneumoniae in lower respiratory tract infections in adults

Adult Community-Acquired Pneumonia in Central London

Community-acquired pneumonia in chronic obstructive pulmonary disease: a Spanish multicenter study.

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