title: Antibacterial therapy of aspiration pneumonia in patients with methicillin-resistant Staphylococcus aureus-positive sputum: identification of risk factors.
abstract: Inappropriate antimicrobial treatment could adversely affect the recovery of patients with aspiration pneumonia. We attempted to identify inappropriate antibacterial treatment and to determine the standard use of anti-methicillin-resistant Staphylococcus aureus (MRSA) drugs in aspiration pneumonia patients with MRSA-positive in sputum. Aspiration pneumonia patients with MRSA-positive sputum treated between January 2013 and May 2013 were included in this study to determine the risk factors for death during hospitalization. The relationship between anti-MRSA medicine use and death during hospitalization was also investigated. More than 10⁷ MRSA colony-forming units in sputum culture, creatinine clearance of less than 30 mL/min, and quinolone use were found to be risk factors for death during hospitalization. The death rate during hospitalization was significantly lower in cases a Geckler classification of 4 or 5 when anti-MRSA treatment was initiated soon after the culture was obtained. Therefore, we concluded that the use of quinolones as antibacterial treatment in aspiration pneumonia patients with MRSA-positive sputum should be avoided and that anti-MRSA treatment should be started in cases with good quality sputum cultures.
authors.forename: Y
authors.initials: Y
authors.lastname: Shinoda
authors.forename: T
authors.initials: T
authors.lastname: Matsuoka
authors.forename: T
authors.initials: T
authors.lastname: Mori
authors.forename: S
authors.initials: S
authors.lastname: Yoshida
authors.forename: K
authors.initials: K
authors.lastname: Ohashi
authors.forename: T
authors.initials: T
authors.lastname: Yoshimura
authors.forename: T
authors.initials: T
authors.lastname: Sugiyama
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017052:Hospital Mortality; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D011015:Pneumonia, Aspiration / Q000188:drug therapy* / Q000382:microbiology* / Q000401:mortality; D015363:Quinolones / Q000627:therapeutic use; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones