Author, as appears in the article.: Arnold FW, Lopardo G, Wiemken TL, Kelley R, Peyrani P, Mattingly WA, Feldman C, Gnoni M, Maurici R, Ramirez JA, Community-Acquired Pneumonia Organization (CAPO)

Department: Medicina i Cirurgia

URV's Author/s: Porras Ledantes, Jose Antonio

Keywords: Randomized controlled-trials Pneumococcal pneumonia Outcomes Mortality Monotherapy Metaanalysis Hospitalized-patients Diagnosis Community-acquired pneumonia Beta-lactam Bacteremia Antimicrobial treatment Antibiotic-treatment Adults community-acquired pneumonia bacteremia antimicrobial treatment

Abstract: © 2018 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.

Thematic Areas: Saúde coletiva Respiratory system Química Pulmonary and respiratory medicine Nutrição Medicina iii Medicina ii Medicina i Interdisciplinar General medicine Engenharias iv Enfermagem Educação física Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciências ambientais Cardiac & cardiovascular systems Biotecnología

licence for use: https://creativecommons.org/licenses/by/3.0/es/

ISSN: 09546111

Author's mail: joseantonio.porras@urv.cat

Author identifier: 0000-0001-6418-1822

Record's date: 2023-02-22

Papper version: info:eu-repo/semantics/acceptedVersion

Link to the original source: https://www.resmedjournal.com/article/S0954-6111(18)30191-4/fulltext

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Respiratory Medicine. 140 115-121

APA: Arnold FW, Lopardo G, Wiemken TL, Kelley R, Peyrani P, Mattingly WA, Feldman C, Gnoni M, Maurici R, Ramirez JA, Community-Acquired Pneumonia Organizat (2018). Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia. Respiratory Medicine, 140(), 115-121. DOI: 10.1016/j.rmed.2018.05.020

Article's DOI: 10.1016/j.rmed.2018.05.020

Entity: Universitat Rovira i Virgili

Journal publication year: 2018

Publication Type: Journal Publications