Background: Community-acquired pneumonia (CAP) has a potential complication of bacteremia. The objective of this study was to define the clinical outcomes of patients with CAP and bacteremia treated with and without a macrolide. Materials and methods: Secondary analysis of the Community-Acquired Pneumonia Organization database of hospitalized patients with CAP. Patients with a positive blood culture were categorized based on the presence or absence of a macrolide in their initial antimicrobial regimen, and severity of their CAP. Outcomes included in-hospital all-cause mortality, 30-day mortality, length of stay, and time to clinical stability. Results: Among 549 patients with CAP and bacteremia, 247 (45%) were treated with a macrolide and 302 (55%) were not. The primary pathogen was Streptococcus pneumoniae (74%). Poisson regression with robust error variance models were used to compare the adjusted effects of each study group on the outcomes. The unadjusted 30-day mortality was 18.4% in the macrolide group, and 29.6% in the non-macrolide group (adjusted relative risk (aRR)0.81; 95% confidence interval (CI)0.50–1.33; P = 0.41). Unadjusted in-hospital all-cause mortality was 7.3% in the macrolide group, and 18.9% in the non-macrolide group (aRR 0.54, 95% CI 0.30–0.98; P = 0.043). Length of stay and time to clinical stability were not significantly different. Conclusions: In-hospital mortality, but not 30-day mortality, was significantly better in the macrolide group. Our data support the use of a macrolide in hospitalized patients with CAP and bacteraemia.
Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia / F.W. Arnold, G. Lopardo, T.L. Wiemken, R. Kelley, P. Peyrani, W.A. Mattingly, C. Feldman, M. Gnoni, R. Maurici, J.A. Ramirez, F. Arnold, P. Peyrani, J. Ramirez, K. Ayesu, T. File, S. Burdette, S. Blatt, M. Restrepo, J. Bordon, P. Gross, D. Musher, T. Marrie, K. Weiss, J. Roig, H. Lode, T. Welte, S. Aliberti, F. Blasi, R. Cosentini, D. Legnani, F. Franzetti, N. Montano, G. Cervi, P. Rossi, A. Voza, B. Ostrowsky, A. Pesci, S. Nava, P. Viale, V. Galavatti, A. Patricia, C. Dimas, R. Piro, C. Viscoli, A. Torres, V. Valenti, D.P. Ojales, M. Bodi, J. Porras, J. Rello, R. Menendez, D. Stolz, P. Schuetz, S. Haubitz, J. Chalmers, T. Fardon, G. Benchetrit, E. Rodriguez, J. Corral, J. Gonzalez, L. de Vedia, G. Lopardo, C. Luna, J. Martinez, L. Marzoratti, M. Rodriguez, A. Videla, F. Saavedra, H. Lopez, M. Gnoni, J. Gonzalez, C. Victorio, F. Riera, P. Jimenez, P. Fernandez, M. Parada, A.D. Fuenzalida, R. Riquelme, M. Barros, J.M. Luna, I. Toala, G.A. Oze de Morvil, R. Fernandez, G. Aiello, P. Alvarez, A. Soca, F. Arteta, J. Delgado, G. Levy, L. Rivero, B. Rodriguez, M.P. Mirabal, M. Mateo, M. Mendoza, C. Feldman. - In: RESPIRATORY MEDICINE. - ISSN 0954-6111. - 140(2018), pp. 115-121.
|Titolo:||Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia|
|Parole Chiave:||Antimicrobial treatment; Bacteremia; Community-acquired pneumonia; Mortality; Pulmonary and Respiratory Medicine|
|Settore Scientifico Disciplinare:||Settore MED/10 - Malattie dell'Apparato Respiratorio|
|Data di pubblicazione:||2018|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.rmed.2018.05.020|
|Appare nelle tipologie:||01 - Articolo su periodico|
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