Cephalosporin-resistant pneumococcal pneumonia: does it, affect outcome?
OBJECTIVE
Penicillin resistance has been reported in various studies to have no impact on the outcome of pneumococcal pneumonia. However, the importance of cephalosporin resistance has not been systematically studied. We conducted an analysis of patients with high-level cephalosporin-resistant Streptococcus pneumoniae pneumonia (H-CRSPP).


METHODS
Retrospective matched, case-control study.


METHODS
Two inner-city academic hospitals.


METHODS
Twenty-six patients with H-CRSPP admitted to the hospital between 1995 and 1999 were identified. Each patient was matched with two controls with cephalosporin-sensitive but oxacillin-resistant pneumococcal pneumonia admitted during the same time period. Matching was done based on pneumonia severity of illness index (PSI) and for other factors.


METHODS
None.


RESULTS
We evaluated a number of outcomes including mortality length of stay in the hospital, and time to respond to treatment. Patients with H-CRSPP took longer to respond to treatment (6.5 +/- 0.9 days vs 4.1 +/- 0.7 days, P=0.05) and had a longer length of stay in hospital (15.4 +/- 2.2 days vs 92 +/- 1.6 days, P=0.02). None of the other outcomes were different between the two groups.


CONCLUSIONS
Overall, we have found that the presence of cephalosporin resistance does impact the course of pneumococcal pneumonia.
Ailani
R K
RK
Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan 48202, USA.
Alimchandani
A
A
Hidalgo
J
J
Ailani
R
R
Buckley
J
J
DiGiovine
B
B
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D018550:Cephalosporin Resistance; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome