title: Severity and outcomes of community acquired pneumonia in asthmatic patients.
abstract: BACKGROUND
  Limited information is available about clinical outcomes and microbiology of community-acquired pneumonia in asthma.
  
  
  METHODS
  We prospectively studied 4079 CAP patients over a 12-years period and found 139 (3.4%) asthmatic patients.
  
  
  RESULTS
  Asthmatics showed younger age (57 ± 19 vs. 66 ± 19 years), less males (32% vs. 68%) and less active smokers (15% vs. 25%). Moreover, they had used more frequently inhaled corticosteroids (ICs, 53% vs. 17%, p < 0.001) and antibiotics (32% vs. 24%, p = 0.041). In comparison with non asthma-CAP, asthmatics showed at admission more pleuritic pain and dyspnoea but less severe pneumonia (PSI, CURB-65, PaO(2)/FIO(2) ratio; p < 0.05). No differences were observed in CAP microbiology, being Streptococcus pneumoniae the most frequent isolate. Clinical outcomes in asthmatic patients were similar to the general population (mortality, mechanical ventilation, etc.) but with a shorter median length of stay (6 [3; 9] vs. 7 [4; 10] days, p = 0.023). The chronic use of ICs did not influence clinical presentation and outcomes among asthmatic patients.
  
  
  CONCLUSIONS
  Asthmatics were younger and showed similar clinical presentation. Consistently with PSI, asthmatics showed similar outcomes than the general population. The microbial aetiology of CAP in asthma did not differ from the general population and antibiotic therapy should follow current guidelines.
authors.affiliation: Respiratory Unit, San Paolo Hospital, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy; Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Terraneo
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Polverino
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Catia
authors.initials: C
authors.lastname: Cilloniz
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Rosanel
authors.initials: R
authors.lastname: Amaro
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: M del Carmen
authors.initials: Mdel C
authors.lastname: Vennera
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Gabarrus
authors.affiliation: Department of Pneumology, Hospital La Fe Valencia, Ciber de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Montull
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Encarnación
authors.initials: E
authors.lastname: Moreno
authors.affiliation: Department of Pneumology, Hospital La Fe Valencia, Ciber de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Rosario
authors.initials: R
authors.lastname: Menendez
authors.affiliation: Respiratory Unit, San Paolo Hospital, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Centanni
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain. Electronic address: atorres@clinic.ub.es.
authors.forename: Antoni
authors.initials: A
authors.lastname: Torres
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D017714:Community-Acquired Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids
keywords: Asthma; Community-acquired pneumonia; Respiratory infections