Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study

• Tipo: Artigo em Revista Científica Internacional
• Data: 2018

Autores

Pereira, JM (Autor) Outra; Goncalves Pereira, J (Autor) Outra; Ribeiro, O (Autor) Outra; Baptista, JP (Autor) Outra; Froes, F (Autor) Outra; Paiva, J-A (Autor) FMUP

Revista

Título: Journal of Critical Care

Vol. 43

Páginas: 183-189

ISSN: 0883-9441

Editora: Elsevier

Indexação

ISI Web of Knowledge - 23 Citações

Scopus - 22 Citações

Outras Informações

ID Authenticus: P-00N-ACQ

DOI: 10.1016/j.jcrc.2017.08.048

Abstract (EN): Antibiotic therapy (AT) is the cornerstone of the management of severe community-acquired pneumonia (CAP). However, the best treatment strategy is far from being established. To evaluate the impact of different aspects of AT on the outcome of critically ill patients with CAP, we performed a post hoc analysis of all CAP patients enrolled in a prospective, observational, multicentre study. Of the 502 patients included, 76% received combination therapy, mainly a beta-lactam with a macrolide (80%). AT was inappropriate in 16% of all microbiologically documented CAP (n = 177). Hospital and 6 months mortality were 34% and 35%. In adjusted multivariate logistic regression analysis, combination AT with a macrolide was independently associated with a reduction in hospital (OR 0.17, 95% CI 0.06-0.51) and 6 months (OR 0.21, 95% CI 0.07-0.57) mortality. Prolonged AT (>7 days) was associated with a longer ICU (14 vs. 7 days; p < 0.001) and hospital length of stay (LOS) (25 vs. 17 days; p < 0.001). Combination AT with a macrolide may be the most suitable AT strategy to improve both short and long term outcome of severe CAP patients. AT >7 days had no survival benefit and was associated with a longer LOS.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 7