Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.26/27820 |
Resumo: | 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 β-lactam with a macrolide (80%). AT was inappropriate in 16% of all microbiologically documented CAP (n=177). Hospital and 6months 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 6months (OR 0.21, 95%CI 0.07-0.57) mortality. Prolonged AT (>7days) was associated with a longer ICU (14 vs. 7days; p<0.001) and hospital length of stay (LOS) (25 vs. 17days; 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 >7days had no survival benefit and was associated with a longer LOS. |
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Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci studyAntibacterianosInfecções Comunitárias AdquiridasDoença CríticaPneumonia BacterianaAntibiotic 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 β-lactam with a macrolide (80%). AT was inappropriate in 16% of all microbiologically documented CAP (n=177). Hospital and 6months 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 6months (OR 0.21, 95%CI 0.07-0.57) mortality. Prolonged AT (>7days) was associated with a longer ICU (14 vs. 7days; p<0.001) and hospital length of stay (LOS) (25 vs. 17days; 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 >7days had no survival benefit and was associated with a longer LOS.Repositório ComumPereira, JMGonçalves-Pereira, JRibeiro, OBaptista, JPFroes, FPaiva, JA2019-02-13T21:34:40Z2018-022018-02-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/27820engJ Crit Care. 2018 Feb;43:183-189.10.1016/j.jcrc.2017.08.048info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-10T05:01:55Zoai:comum.rcaap.pt:10400.26/27820Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:35:38.380172Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study |
title |
Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study |
spellingShingle |
Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study Pereira, JM Antibacterianos Infecções Comunitárias Adquiridas Doença Crítica Pneumonia Bacteriana |
title_short |
Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study |
title_full |
Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study |
title_fullStr |
Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study |
title_full_unstemmed |
Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study |
title_sort |
Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study |
author |
Pereira, JM |
author_facet |
Pereira, JM Gonçalves-Pereira, J Ribeiro, O Baptista, JP Froes, F Paiva, JA |
author_role |
author |
author2 |
Gonçalves-Pereira, J Ribeiro, O Baptista, JP Froes, F Paiva, JA |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Comum |
dc.contributor.author.fl_str_mv |
Pereira, JM Gonçalves-Pereira, J Ribeiro, O Baptista, JP Froes, F Paiva, JA |
dc.subject.por.fl_str_mv |
Antibacterianos Infecções Comunitárias Adquiridas Doença Crítica Pneumonia Bacteriana |
topic |
Antibacterianos Infecções Comunitárias Adquiridas Doença Crítica Pneumonia Bacteriana |
description |
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 β-lactam with a macrolide (80%). AT was inappropriate in 16% of all microbiologically documented CAP (n=177). Hospital and 6months 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 6months (OR 0.21, 95%CI 0.07-0.57) mortality. Prolonged AT (>7days) was associated with a longer ICU (14 vs. 7days; p<0.001) and hospital length of stay (LOS) (25 vs. 17days; 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 >7days had no survival benefit and was associated with a longer LOS. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-02 2018-02-01T00:00:00Z 2019-02-13T21:34:40Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.26/27820 |
url |
http://hdl.handle.net/10400.26/27820 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
J Crit Care. 2018 Feb;43:183-189. 10.1016/j.jcrc.2017.08.048 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799134920787886080 |