Publication: Addition of a macrolide to a b-Lactam–Based empirical antibiotic regimen Is associated with lower in-hospital mortality for patients with bacteremic pneumococcal pneumonia
Authors
Martínez, José A. ; Horcajada, Juan P. ; Almela, Manuel ; Marco, Francesc ; Soriano, Alex ; García-Vázquez, Elisa ; Marco, Maria Ángeles ; Torres, Antoni ; Mensa, Josep
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Publisher
Oxford University Press
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DOI
https://doi.org/10.1086/367541
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info:eu-repo/semantics/article
Description
©2003 by the Infectious Diseases Society of America. All rights reserved. This document is the Published, version of a Published Work that appeared in final form in Clinical Infectious Diseases . To access the final edited and published work see https://doi.org/10.1086/367541
Abstract
To assess the association between inclusion of a macrolide in a b-lactam–based empirical antibiotic regimen
and mortality among patients with bacteremic pneumococcal pneumonia, 10 years of data from a database
were analyzed. The total available set of putative prognostic factors was subjected to stepwise logistic regression,
with in-hospital death as the dependent variable. Of the 409 patients analyzed, 238 (58%) received a b-lactam
plus a macrolide and 171 (42%) received a b-lactam without a macrolide. Multivariate analysis revealed 4
variables to be independently associated with death: shock ( ), age of 65 years ( ), infectionsP ! .0001 P .02
with pathogens that have resistance to both penicillin and erythromycin ( ), and no inclusion of aP p .04
macrolide in the initial antibiotic regimen ( ). For patients with bacteremic pneumococcal pneumonia,P p .03
not adding a macrolide to a b-lactam–based initial antibiotic regimen is an independent predictor of inhospital mortality. However, only a randomized study can definitively determine whether this association is due to a real effect of macrolides.
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Citation
Clinical Infectious Diseases. 2003, 36 (4): 389–395
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