Antibiotic Therapy and 48-Hour Mortality for Patients with Pneumonia

Eric M. Mortensen, Marcos I. Restrepo, Antonio Anzueto, Jacqueline A. Pugh

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Purpose: Although numerous articles have demonstrated that recommended empiric antimicrobial regimens are associated with decreased mortality at 30 days, there is controversy over whether appropriate antibiotic selection has a beneficial impact on mortality within the first 48 to 96 hours after admission. Our aim was to determine whether the use of guideline-concordant antibiotic therapy is associated with decreased mortality within the first 48 hours after admission for patients with pneumonia. Methods: A retrospective cohort study was conducted at two tertiary teaching hospitals in San Antonio, Texas. A propensity score was used to balance the covariates associated with the use of guideline-concordant antimicrobial therapy. A multivariable logistic regression model was used to assess the association between mortality within 48 hours and the use of guideline-concordant antibiotic therapy, after adjusting for potential confounders including the propensity score. Results: Information was obtained on 787 patients with community-acquired pneumonia. The median age was 60 years, 79% were male, and 20% were initially admitted to the intensive care unit. At presentation 52% of subjects were low risk, 34% were moderate risk, and 14% were high risk. Within the first 48 hours, 20 patients died. After adjustment for potential confounders, the use of guideline-concordant antimicrobial therapy (odds ratio 0.37, 95% confidence interval, 0.14-0.95) was significantly associated with decreased mortality at 48 hours after admission. Conclusion: Using initial empiric guideline-concordant antimicrobial therapy is associated with decreased mortality at 48 hours. Further research needs to investigate methods to ensure that patients with community-acquired pneumonia are treated with appropriate antimicrobial therapies.

Original languageEnglish (US)
Pages (from-to)859-864
Number of pages6
JournalAmerican Journal of Medicine
Volume119
Issue number10
DOIs
StatePublished - Oct 1 2006

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Keywords

  • Antibacterial agents
  • Community-acquired infections
  • Pneumonia

ASJC Scopus subject areas

  • Medicine(all)

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