Single versus combination antibiotic therapy in adults hospitalised with community acquired pneumonia.
The benefits of β-lactam/macrolide combination therapy over β-lactam therapy alone for the treatment of hospitalised community-acquired pneumonia (CAP) in relation to pneumonia severity are uncertain. We studied 5240 adults hospitalised with CAP from 72 secondary care trusts across England and Wales. The overall 30-day inpatient (IP) death rate was 24.4%. Combination therapy was prescribed in 3239 (61.8%) patients. In a multivariable model, combination therapy was significantly associated with lower 30-day IP death rate in patients with moderate-severity CAP (adjusted OR 0.54, 95% CI 0.41 to 0.72) and high-severity CAP (adjusted OR 0.76, 95% CI 0.60 to 0.96) but not low-severity CAP.
Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK. chamira@doctors.org.uk
Chamira
C
Rodrigo
Tricia M
TM
Mckeever
Mark
M
Woodhead
Wei Shen
WS
Lim
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000401:mortality; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014852:Wales / Q000453:epidemiology; D055815:Young Adult
D000900:Anti-Bacterial Agents