Publication: Lower mortality among patients with community-acquired
pneumonia treated with a macrolide plus a beta-lactam
agent versus a beta-lactam agent alone
Authors
García Vázquez ·, E. ; Mensa, J. ; Martínez, J. A. ; Marcos, M. A. ; Puig, J. ; Ortega, M. ; Torres, A.
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Publisher
Springer
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DOI
https://doi.org/10.1007/s10096-005-1295-9
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info:eu-repo/semantics/article
Description
© Springer-Verlag 2005 This document is the published version of a published work that appeared in final form in
European Journal of Clinical Microbiology and Infectious Diseases (EJCMID)
To access the final work, see DOI: https://doi.org/10.1007/s10096-005-1295-9
Abstract
A cohort of 1,391 patients with community
acquired pneumonia of unknown etiology, atypical pneu
monia, Legionella pneumophila pneumonia, viral pneumo
nia, or pneumococcal pneumonia was studied according to
a standard protocol to analyse whether the addition of a
macrolide to β-lactam empirical treatment decreases mor
tality rates. Patients admitted to the intensive care unit were
excluded. Severity was assessed using the PORT score. An
etiological diagnosis was achieved in 498 (35.8%) patients
(292 infections due to Streptococcus pneumoniae). Treat
ment was chosen by the attending physician according to
his/her own criteria: β-lactam agent in 270 and β-lactam
agent plus a macrolide in 918 cases. The mortality rate was
13.3% in the group treated with a β-lactam agent alone
and 6.9% in the group treated with a β-lactam agent plus
a macrolide (p=0.001). The percentage of PORT-group V
patients was 32.6% in the group treated with a beta-lactam
agent alone compared to 25.7% in the group who received
a β-lactam agent plus a macrolide (p=0.02). After control
ling for PORT score, the odds of fatal outcome was two
times higher in patients treated with a beta-lactam agent
alone than in those treated with a β-lactam agent plus a macrolide (adjusted OR = 2, 95%CI 1.24–3.23). The re
sults suggest that the addition of a macrolide to an initial
β-lactam-based antibiotic regimen is associated with lower
mortality in patients with community-acquired pneumo
nia, independent of severity of infection, thus supporting
the recommendation of a β-lactam-agent plus a macrolide
as empirical therapy.
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Citation
García Vázquez, E., Mensa, J., Martínez, J.A. et al. Lower mortality among patients with community-acquired pneumonia treated with a macrolide plus a beta-lactam agent versus a beta-lactam agent alone. Eur J Clin Microbiol Infect Dis 24, 190–195 (2005). https://doi.org/10.1007/s10096-005-1295-9
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