High alcohol intake as a risk and prognostic factor for community-acquired pneumonia.
OBJECTIVE
To evaluate whether high alcohol intake is an independent risk factor for community-acquired pneumonia in middle-aged people and whether it confers a poor prognosis.


METHODS
A two-phase study was performed. Risk factors for community-acquired pneumonia were evaluated in a case-control study of 50 patients and 50 controls. Prognostic factors and microbiologic and clinical features were then evaluated in a cohort study of the 50 middle-aged patients with community-acquired pneumonia.


RESULTS
In the first study, the only independent risk factor for community-acquired pneumonia was high alcohol intake (P < .02). In the second study, patients with chronic alcoholism had a higher incidence of pneumonia caused by gram-negative bacilli (P < .03), as well as a higher incidence of Candida albicans (P < .03), Staphylococcus aureus (P < .0001), and gram-negative bacilli (P < .001) in the cultures of pharyngeal smears than did the nonalcoholics. Compared with nonalcoholic patients, alcoholic patients with pneumonia showed more severe clinical symptoms (P < .02), required longer intravenous treatment (P < .02) and longer hospital stay (P < .01), and had multilobar involvement and pleural effusion (both P < .01), as well as slower resolution of pulmonary infiltrates. The only prognostic factor for mortality was high alcohol intake (P < .03).


CONCLUSIONS
High alcohol intake is the main risk factor for developing community-acquired pneumonia in middle-aged people. This situation also confers a worse prognosis in these patients, who should be treated with broad-spectrum antibiotics for a longer period.
Fernández-Solá
J
J
Department of Internal Medicine, Hospital Clínic, University of Barcelona, Spain.
Junqué
A
A
Estruch
R
R
Monforte
R
R
Torres
A
A
Urbano-Márquez
A
A
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D016022:Case-Control Studies; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology* / Q000382:microbiology; D011379:Prognosis; D012307:Risk Factors