Hospitalized patients with community-acquired pneumonia in Hong Kong: a randomized study comparing imipenem/cilastatin and ceftazidime.
The aetiology and outcome of hospitalized patients with moderate to severe community-acquired pneumonia (CAP) were evaluated in 60 adult patients (38 male 22 female, mean age 68.4 years). They were randomized for treatment with either ceftazidime or imipenem/cilastatin intravenously for 7 days. Bacteriological diagnoses were made in 25 cases (41.6%): Streptococcus pneumoniae (5), Haemophilus influenzae (5), Pseudomonas spp. in particular Pseudomonas aeruginosa (8), Staphylococcus aureus (4), Chlamydia spp. (2), Mycobacterium tuberculosis (2) and Moraxella catarrhalis (3); mixed organisms were found in 4 patients. Forty-two patients (70%) responded satisfactorily to the regimens with improvement in sputum purulence cough and dyspnoea scores; there was no difference in response between the two groups. Sixteen patients (26.6%) underwent bronchoscopy on day 4 because of inadequate response to the antibiotics regimens, and 9 of them (15%) required a modification of the initial treatment with addition of erythromycin in 5 patients vancomycin in 1 cloxacillin in 1 and antituberculous drugs in 2. Three out of the 60 patients (5%) died of pulmonary sepsis: the aetiological agents were M. tuberculosis in one, Pseudomonas spp./methicillin-resistant S. aureus in another, but were not identified in the third. We conclude that treatment with either ceftazidime or imipenem/cilastatin was efficacious for moderate to severe CAP in Hong Kong.
Ho
A
A
Department of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong.
Leung
R
R
Lai
C K
CK
Chan
T H
TH
Chan
C H
CH
D000328:Adult; D000368:Aged; D002442:Ceftazidime / Q000008:administration & dosage / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D015377:Cilastatin / Q000008:administration & dosage / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006760:Hospitalization; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000627:therapeutic use*; D007275:Injections, Intravenous; D008297:Male; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D011480:Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D015996:Survival Rate; D013845:Thienamycins / Q000008:administration & dosage / Q000627:therapeutic use*
D002511:Cephalosporins; D011480:Protease Inhibitors; D013845:Thienamycins; D015377:Cilastatin; D015378:Imipenem; D002442:Ceftazidime