Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia.
Retrospective studies have suggested that combination antibiotic therapy for severe bacteremic pneumococcal pneumonia may reduce mortality. We assessed this issue in a prospective, multicenter, international observational study of 844 adult patients with bacteremia due to Streptococcus pneumoniae. The effect of combination antibiotic therapy versus monotherapy on mortality was examined by univariate analyses and by logistic regression models. The 14-day mortality was not significantly different for the two groups. However, among critically ill patients, combination antibiotic therapy was associated with lower 14-day mortality (23.4 versus 55.3%, p = 0.0015). This improvement in survival was independent of country of origin, intensive care unit support, class of antibiotics, or in vitro activity of the antibiotics prescribed. Combination antibiotic therapy improved survival among critically ill patients with bacteremic pneumococcal illness.
Baddour
Larry M
LM
Mayo Clinic, Rochester, NY, USA.
Yu
Victor L
VL
Klugman
Keith P
KP
Feldman
Charles
C
Ortqvist
Ake
A
Rello
Jordi
J
Morris
Arthur J
AJ
Luna
Carlos M
CM
Snydman
David R
DR
Ko
Wen Chien
WC
Chedid
M Bernadete F
MB
Hui
David S
DS
Andremont
Antoine
A
Chiou
Christine C C
CC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000188:drug therapy* / Q000401:mortality*; D003422:Critical Care / Q000379:methods; D016638:Critical Illness; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000401:mortality*; D011446:Prospective Studies; D016019:Survival Analysis
D000900:Anti-Bacterial Agents