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Pàgina inicial > Articles > Articles publicats > Improvement of antibiotic therapy and ICU survival in severe non-pneumococcal community-acquired pneumonia : |
Data: | 2015 |
Resum: | We aimed to compare intensive care unit mortality due to non-pneumococcal severe community-acquired pneumonia between the periods 2000-2002 and 2008-2014, and the impact of the improvement in antibiotic strategies on outcomes. This was a matched case-control study enrolling 144 patients with non-pneumococcal severe pneumonia: 72 patients from the 2000-2002 database (CAPUCI I group) were paired with 72 from the 2008-2014 period (CAPUCI II group), matched by the following variables: microorganism, shock at admission, invasive mechanical ventilation, immunocompromise, chronic obstructive pulmonary disease, and age over 65 years. The most frequent microorganism was methicillin-susceptible Staphylococcus aureus (22. 1 %) followed by Legionella pneumophila and Haemophilus influenzae (each 20. 7 %); prevalence of shock was 59. 7 %, while 73. 6 % of patients needed invasive mechanical ventilation. Intensive care unit mortality was significantly lower in the CAPUCI II group (34. 7 % versus 16. 7 %; odds ratio (OR) 0. 78, 95 % confidence interval (CI) 0. 64-0. 95; p = 0. 02). Appropriate therapy according to microorganism was 91. 5 % in CAPUCI I and 92. 7 % in CAPUCI II, while combined therapy and early antibiotic treatment were significantly higher in CAPUCI II (76. 4 versus 90. 3 % and 37. 5 versus 63. 9 %; p < 0. 05). In the multivariate analysis, combined antibiotic therapy (OR 0. 23, 95 % CI 0. 07-0. 74) and early antibiotic treatment (OR 0. 07, 95 % CI 0. 02-0. 22) were independently associated with decreased intensive care unit mortality. In non-pneumococcal severe community-acquired pneumonia, early antibiotic administration and use of combined antibiotic therapy were both associated with increased intensive care unit survival during the study period. |
Ajuts: | Agència de Gestió d'Ajuts Universitaris i de Recerca 2014SGR0218 Instituto de Salud Carlos III RTIC03/11 Instituto de Salud Carlos III PI04/1500 |
Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. |
Llengua: | Anglès |
Document: | Article ; recerca ; Versió publicada |
Publicat a: | Critical Care, Vol. 19 (september 2015) , ISSN 1466-609X |
12 p, 1000.8 KB |