Antibiotic Prescribing for Adults Hospitalized in the Etiology of Pneumonia in the Community Study

Tomczyk, Sara; Jain, Seema; Bramley, Anna M.; Self, Wesley H.; Anderson, Evan J.; Trabue, Chris; Courtney, D. Mark; Grijalva, Carlos G.; Waterer, Grant; Edwards, Kathryn M.; Wunderink, Richard G.; Hicks, Lauri A.

doi:10.1093/ofid/ofx088

Cited by 14 publications

(12 citation statements)

References 31 publications

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“…have been treated with fluoroquinolones, piperacillin/tazobactam, meropenem, or polymyxin B, as monotherapy or combination therapy ( Chart 6 ). 92 , 93 …”

Section: Recommendations For Pathogen-specific Targeted Therapy In Pmentioning

confidence: 99%

2018 recommendations for the management of community acquired pneumonia

et al. 2018

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Community-acquired pneumonia (CAP) is the leading cause of death worldwide. Despite the vast diversity of respiratory microbiota, Streptococcus pneumoniae remains the most prevalent pathogen among etiologic agents. Despite the significant decrease in the mortality rates for lower respiratory tract infections in recent decades, CAP ranks third as a cause of death in Brazil. Since the latest Guidelines on CAP from the Sociedade Brasileira de Pneumologia e Tisiologia (SBPT, Brazilian Thoracic Association) were published (2009), there have been major advances in the application of imaging tests, in etiologic investigation, in risk stratification at admission and prognostic score stratification, in the use of biomarkers, and in the recommendations for antibiotic therapy (and its duration) and prevention through vaccination. To review these topics, the SBPT Committee on Respiratory Infections summoned 13 members with recognized experience in CAP in Brazil who identified issues relevant to clinical practice that require updates given the publication of new epidemiological and scientific evidence. Twelve topics concerning diagnostic, prognostic, therapeutic, and preventive issues were developed. The topics were divided among the authors, who conducted a nonsystematic review of the literature, but giving priority to major publications in the specific areas, including original articles, review articles, and systematic reviews. All authors had the opportunity to review and comment on all questions, producing a single final document that was approved by consensus.

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“…have been treated with fluoroquinolones, piperacillin/tazobactam, meropenem, or polymyxin B, as monotherapy or combination therapy ( Chart 6 ). 92 , 93 …”

Section: Recommendations For Pathogen-specific Targeted Therapy In Pmentioning

confidence: 99%

2018 recommendations for the management of community acquired pneumonia

et al. 2018

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“…[19] In one study, non-ICU patients received a respiratory fluoroquinolone alone 33% of the time or beta-lactam plus macrolide (19%). [20] In an Australian study, ceftriaxone and azithromycin combination was used for 56% of the patients[21] and one-third of patients with CAP in an Indian study received macrolide and a beta-lactam. [22]…”

Section: Discussionmentioning

confidence: 99%

Empiric antibiotic therapy in the treatment of community-acquired pneumonia in a general hospital in Saudi Arabia

Al‐Tawfiq

Momattin

Hinedi

2019

J Global Infect Dis

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Background: Guideline-based empiric antimicrobial therapy is recommended for the treatment of community-acquired pneumonia (CAP). In this study, we evaluate the pattern of empiric antibiotics of CAP patients. Materials and Methods: Patients with CAP were retrieved from the health information unit using the International Classification of Diseases, Ninth Revision. The electronic pharmacy database was used to retrieve prescribed antibiotics and the duration of therapy for each antibiotic. Results: A total of 1672 adult patients were included in the study and 868 (52%) were male. Of all the patients, 47 (2.8%) were admitted to the intensive care unit (ICU). The most frequently used antibiotics were levofloxacin (68.12%), ceftriaxone (37.7%), imipenem-cilastatin (32.5%), and azithromycin (20.6%). The mean days of therapy of each of these antibiotics were 3.2, 2.8, 4.4, and 2.9, respectively. A combination therapy of levofloxacin and imipenem-cilastatin was prescribed for 355 (21.8%) of non-ICU patients versus 20 (60.6%) of ICU patients ( P = 0.0007). Imipenem-cilastatin was prescribed for 518 (31.8%) of non-ICU patients versus 25 (56.8%) of ICU patients ( P = 0.0009). Levofloxacin was prescribed for 1106 (68%) of non-ICU patients versus 33 (75%) of ICU patients ( P = 0.412). Ceftriaxone use decreased significantly from 40.9% in 2013 to 25.9% in 2016 ( P = 0.034). In addition, levofloxacin use increased from 63.7% to 75% ( P = 0.63). Conclusion: The most commonly used antibiotics were levofloxacin, ceftriaxone, imipenem-cilastatin, and azithromycin. The data call for further refinement and prospective audit of antibiotic use in CAP, especially in non-ICU settings.

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“…Moreover, this HCAP definition promoted the use of broad-spectrum antibiotics as empirical treatment in the setting of CAP. 69 Concerns about adverse events and antibiotic resistance in patients who received broad spectrum antibiotic therapy were raised and an increasing body of evidence showed a greater risk of mortality in patients with HCAP risk factors who received broad-spectrum therapy relative to patients treated with standard CAP therapy. 70,71 To address these limitations of the HCAP definition, scientists developed multiple clinical prediction models attempting to identify MDR pathogens in CAP.…”

Section: Risk Factors Associated With Resistant Gnb In Capmentioning

confidence: 99%

Emerging Resistance of Gram Negative Pathogens in Community-Acquired Pneumonia

Amati

Restrepo²

2020

Semin Respir Crit Care Med

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AbstractIn recent decades, there has been a growing interest about the role of gram negative bacteria in community-acquired pneumonia (CAP), especially Pseudomonas aeruginosa, Enterobacteriaceae, and Acinetobacter baumannii. The prevalence of these pathogens differs largely according to the local ecology and the geographical location. Identifying gram negative bacteria, and in particular resistant gram negative bacteria, is of paramount importance in patients with CAP because these pathogens are associated with higher clinical severity and unfavorable outcomes. The use of individualized risk factors to predict each pathogen is a helpful strategy that needs to be locally validated. However, it should be taken into account that most of the risk factors identified in the literature are heterogeneously defined or lack consistency. New diagnostic techniques, such as molecular testing, are promising methods for early detection of these gram negative pathogens. The increasing mechanisms of resistance to antibiotics of these pathogens have limited our therapeutic approach. This narrative review focuses on the epidemiology, risk factors, diagnosis, and therapeutic options for the most relevant gram negative bacteria that cause CAP.

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Antibiotic Prescribing for Adults Hospitalized in the Etiology of Pneumonia in the Community Study

Cited by 14 publications

References 31 publications

2018 recommendations for the management of community acquired pneumonia

2018 recommendations for the management of community acquired pneumonia

Empiric antibiotic therapy in the treatment of community-acquired pneumonia in a general hospital in Saudi Arabia

Emerging Resistance of Gram Negative Pathogens in Community-Acquired Pneumonia

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