[Community-acquired pneumonia: attitude case of treatment failure].
It can be determined that for nearly one out of five patients hospitalized for a community-acquired pneumonia the empirical treatment chosen will fail. Those for whom the treatment failed face a bad outcome with a mortality rate as a high as 43%. Most causes of failure can be attributable to the patient rather than to the antibiotic or to the pathogen. The studies related to treatment failure show that resistance of the causal agent to antibiotic is rarely the cause, as opposed to discordant therapy (causal agent not covered by chosen antibiotherapy), which plays an important role. In these studies the multivariate analysis were able to show that concordant therapy (causal agent covered by chosen antibiotherapy), vaccination against influenza, monocytosis and old age were possible protective factors against treatment failure.
Genné
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D
Departement de Médecine interne, Hôpital de la ville, 2300 La Chaux-de-Fonds. daniel.genne@ne.ch
Rakotoarimanana
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R
D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections; D024881:Drug Resistance, Bacterial; D006801:Humans; D007252:Influenza Vaccines; D015999:Multivariate Analysis; D011014:Pneumonia / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D007252:Influenza Vaccines