Background/aim: The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with communityacquired pneumonia in nonintensive care unit (ICU) wards and treated with a β-lactam, β-lactam and macrolide combination, or a fluoroquinolone.
Materials and methods:This prospective cohort study was performed using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey.Results: Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated bacteria were S. pneumoniae (21.8%) and P. aeruginosa (19.2%). The clinical cure rate and length of stay were not different among patients treated with β-lactam, β-lactam and macrolide combination, and fluoroquinolone. Forty-seven patients (9.2%) died during the hospitalization period. There was no difference in survival among the three treatment groups.
Conclusion:In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between β-lactam, β-lactam and macrolide combination, and fluoroquinolone regimens.
Background: Advanced technologies and treatments continue to increase life expectancy, however, the hospital mortality rate of elderly patients with respiratory diseases remains unclear. In this study, we aimed to demonstrate the changing frequencies of hospitalized elderly patients with respiratory diseases and their mortality rates over time.
Objective: Pleural effusion (PE) takes an important place in the clinical practice of thoracic diseases because of the difficulties in establishing an etiological diagnosis. The causes of effusion differ depending on the region where the examination is carried out, the clinic and the population involved. In this study, we aimed to evaluate adult patients who were examined due to PE in our clinic at a specific hospital for chest diseases.
Methods:The recordings of 240 patients who were hospitalised between June 2010 and July 2013 in our clinic and examined due to PE were retrospectively evaluated. Their fluid samples were taken and the patients were exposed to advanced invasive procedures when necessary. Demographic features of the patients, fluid analyses, diagnostic methods and diagnoses were reviewed.
Results:Of the cases, 68% were male. The mean age was 58±20 years and the most common complaint for admission was shortness of breath. The amount of pleural fluid was moderate in 56% of the cases. Eighty seven percent of the fluids were exudative. The concentration of glucose was below 60 mg/dL in 40 patients and the concentration of adenosine deaminase was above 40 U/L in 39 patients. The diagnosis of tuberculosis (TB) pleurisy was established to a great extent. Of the invasive procedures, closed pleural biopsy and fiberoptic bronchoscopy contributed to the diagnosis at rates of 47% and 21%, respectively. Of 61 malignancy-induced PEs, 38 were due to primary lung cancer and 8 were due to malignant mesothelioma. Apart from mesothelioma, 66% of these effusions were malignant effusions and contribution of the initial thoracentesis to this diagnosis was found to be 40%.
Conclusion:In our serial study, the most common causes of PE was TB in female patients, and pneumonia in male patients. Invasive procedures except thoracentesis were performed for 160 cases in total in the study. In 10 cases, the etiology of effusion could not be identified.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.