title: Monotherapy versus combination antibiotic therapy for patients with bacteremic Streptococcus pneumoniae community-acquired pneumonia.
abstract: The purpose of this study was to examine the impact of antimicrobial monotherapy vs combination therapy on length of stay and mortality for patients with Streptococcus pneumoniae pneumonia. Thirty-nine percent of patients received monotherapy, while 61% received combination therapy. Although there was no significant difference in mortality (OR 1.25, 95% CI = 0.25-6.8), there was a significant increase in length of stay for patients who received combination therapy (p = 0.02). Patients with bacteremic pneumococcal pneumonia treated with empiric combination therapy had no significant difference in mortality; however, they did have increased length of stay after adjusting for severity of illness. Randomized controlled trials are needed to determine what is the optimal empiric antimicrobial regime for patients with community-acquired pneumonia.
authors.affiliation: Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284, USA.
authors.forename: R
authors.initials: R
authors.lastname: Chokshi
authors.forename: M I
authors.initials: MI
authors.lastname: Restrepo
authors.forename: N
authors.initials: N
authors.lastname: Weeratunge
authors.forename: C R
authors.initials: CR
authors.lastname: Frei
authors.forename: A
authors.initials: A
authors.lastname: Anzueto
authors.forename: E M
authors.initials: EM
authors.lastname: Mortensen
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000209:etiology; D017714:Community-Acquired Infections / Q000150:complications / Q000188:drug therapy / Q000401:mortality; D004359:Drug Therapy, Combination; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents