Addition of a macrolide to a ss-lactam in bacteremic pneumococcal pneumonia.
In the study presented here, data collected prospectively from 340 adult patients hospitalised in five countries with bacteremic pneumococcal CAP and treated with a ss-lactam +/- a macrolide were analysed retrospectively to evaluate the efficacy of this antimicrobial combination. Univariate and multivariate analyses revealed no significant effect on case fatality rate when a macrolide/ss-lactam regimen was used as initial therapy. Results were not affected by severity of illness, or by excluding patients who died within 2 days of admission. Identified predictors of death in a multivariate regression model were age >65 years (OR=2.6), two or more lung lobes affected (OR=2.2), and severity of disease as estimated using the acute physiology score (APS)>8.
Dwyer
R
R
Department of Medicine, Infectious Disease Unit, Karolinska University Hospital, 14186 Stockholm, Sweden. richard.dwyer@karolinska.se
Ortqvist
A
A
Aufwerber
E
E
Henriques Normark
B
B
Marrie
T J
TJ
Mufson
M A
MA
Torres
A
A
Woodhead
M A
MA
Alenius
M
M
Kalin
M
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007769:Lactams / Q000627:therapeutic use*; D018942:Macrolides / Q000627:therapeutic use*; D008297:Male; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy*; D011446:Prospective Studies; D013296:Streptococcus pneumoniae; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D007769:Lactams; D018942:Macrolides