Incidence of Antibiotic Treatment Failure in Patients with Nursing Home-Acquired Pneumonia and Community Acquired Pneumonia.

Autor: Lopes M; Infectious Diseases Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal., Alves Silva G; Infectious Diseases Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal., Nogueira RF; Nephrology Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal., Marado D; Internal Medicine Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal., Gonçalves J; Internal Medicine Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal., Athayde C; Internal Medicine Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal., Silva D; Internal Medicine Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal., Figueiredo A; Internal Medicine Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal., Fortuna J; Internal Medicine Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal., Carvalho A; Internal Medicine Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal.
Jazyk: angličtina
Zdroj: Infectious disease reports [Infect Dis Rep] 2021 Jan 05; Vol. 13 (1), pp. 33-44. Date of Electronic Publication: 2021 Jan 05.
DOI: 10.3390/idr13010006
Abstrakt: Purpose: Nursing home-acquired pneumonia (NHAP) patients are at higher risk of multi-drug resistant infection (MDR) than those with community-acquired pneumonia (CAP). Recent evidence suggests a single risk factor for MDR does not accurately predict the need for broad-spectrum antibiotics. The goal of this study was to compare the rate antibiotic failure between NHAP and CAP patients.
Methods: Demographic characteristics, co-morbidities, clinical and laboratory variables, antibiotic therapy, and mortality data were collected retrospectively for all patients with pneumonia admitted to an Internal Medicine Service between April 2017 and April 2018.
Results: In total, 313 of 556 patients had CAP and 243 had NHAP. NHAP patients were older, and were more likely to be dependent, to have recent antibiotic use, and to experience treatment failure (odds ratio (OR) 1.583; 95% CI 1.102-2.276; p = 0.013). In multivariate analysis, patient's origin did not predict treatment failure (OR 1.083; 95% CI 0.726-1.616; p = 0.696).
Discussion: Higher rates of antibiotic failure and mortality in NHAP patients were explained by the presence of other risk factors such as comorbidities, more severe presentation, and age. Admission from a nursing home is not a sufficient condition to start broader-spectrum antibiotics.
Databáze: MEDLINE
Externí odkaz: