Clinical outcomes of bacteremic pneumococcal pneumonia in the era of antibiotic resistance

John F. Moroney, Anthony E. Fiore, Lee H. Harrison, Jan E. Patterson, Monica M. Farley, James H. Jorgensen, Maureen Phelan, Richard R. Facklam, Martin S. Cetron, Robert F. Breiman, Margarette Kolczak, Anne Schuchat

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119 Scopus citations

Abstract

Limited data are available about the impact of antimicrobial resistance on clinical outcomes in cases of pneumococcal pneumonia. This was studied in 146 persons hospitalized with invasive pneumonia due to Streptococcus pneumoniae (minimum inhibitory concentration of cefotaxime, 25 g/mL) who were identified through population-based active surveillance for the period of November 1994 through April 1996. Compared with matched control subjects who had infection with more-susceptible S. pneumoniae, the proportion of subjects who died or who were admitted to an intensive care unit did not differ significantly. Multivariable analysis showed no significant contribution of antimicrobial resistance to mortality or the requirement for care in an intensive care unit. The ability to detect an effect of antimicrobial resistance on these important outcome measures may have been influenced by aggressive multidrug empirical therapy in this group of hospitalized patients. Factors other than resistance, such as severity of illness at presentation and advance directive status ("do not resuscitate" orders), appear to have a stronger influence on pneumococcal pneumonia outcomes.

Original languageEnglish (US)
Pages (from-to)797-805
Number of pages9
JournalClinical Infectious Diseases
Volume33
Issue number6
DOIs
StatePublished - Sep 15 2001

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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