Community-acquired Legionella Pneumonia in the intensive care unit: Impact on survival of combined antibiotic therapy
| Autor: | Rello, J., Gattarello, S., Souto, J., Sole Violan, J., Valles, J., Peredo, R., Zaragoza, R., Vidaur, L., Parra, A., Roig, J., Almirall, J., Alonso, R., Alvarez, B., Alvarez Lerma, F., Badia, J. R., Barcenilla, F., Bassetti, Matteo, Blanquer, J., Blasco, M. A., Bobillo, F., Bodi, M., Borges, M., Bouza, E., Broch, M. J., Carrasco, N., Catalan, M., de la Torre, V., Diaz, E., Doblas, A., Fierro, J., Garcia, F., Garnacho, J., Herranz, M. A., Huertos, M. J., Jimenez, J., Jorda, R., Koulentis, D., Lopez, D., Lopez Cambra, M. J., Lopez Pueyo, M. J., Lores, A., Lucena, F., Luque, P., Maiez, R., Maravi, E., Margarit, A., Martin, A., Masdeu, G., Mendia, A., Mesalles, E., Pereira, J., Poulakou, G., Renedo, F., Ricard, J. M., Robles, J. C., Rocha, L., Sierra, R., Sirvent, J. M., Sole, J., Suberviola, B., Torres, A. |
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| Rok vydání: | 2013 |
| Předmět: |
Combined antibiotic therapy
Legionella pneumophila Legionnaires' disease Severe community-acquired pneumonia Anti-Bacterial Agents Community-Acquired Infections Drug Therapy Combination Female Humans Intensive Care Units Legionnaires' Disease Male Middle Aged Pneumonia Bacterial Prospective Studies Survival Rate Critical Care and Intensive Care Medicine medicine.medical_specialty Combination therapy medicine.medical_treatment Legionella Pneumonia law.invention Drug Therapy law Levofloxacin Clarithromycin Internal medicine medicine Mechanical ventilation business.industry Bacterial Pneumonia medicine.disease Intensive care unit Surgery Combination business Rifampicin medicine.drug |
| Zdroj: | Medicina Intensiva. 37:320-326 |
| ISSN: | 0210-5691 |
| DOI: | 10.1016/j.medin.2012.05.010 |
| Popis: | Objectives To compare intensive care unit (ICU) mortality in patients with severe community-acquired pneumonia (SCAP) caused by Legionella pneumophila receiving combined therapy or monotherapy. Methods A prospective multicenter study was made, including all patients with sporadic, community-acquired Legionnaires’ disease (LD) admitted to the ICU. Admission data and information on the course of the disease were recorded. Antibiotic prescriptions were left to the discretion of the attending physician and were not standardized. Results Twenty-five cases of SCAP due to L. pneumophila were included, and 7 patients (28%) out of 25 died after a median of 7 days of mechanical ventilation. Fifteen patients (60%) presented shock. Levofloxacin and clarithromycin were the antibiotics most commonly used in monotherapy, while the most frequent combination was rifampicin plus clarithromycin. Patients subjected to combination therapy presented a lower mortality rate versus patients subjected to monotherapy (odds ratio for death [OR] 0.15; 95%CI 0.02–1.04; p = 0.08). In patients with shock, this association was stronger and proved statistically significant (OR for death 0.06; 95%CI 0.004–0.86; p = 0.04). Conclusions Combined antibiotic therapy decreases mortality in patients with SCAP and shock caused by L. pneumophila. |
| Databáze: | OpenAIRE |
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