Appropriate antibiotic utilization in seniors prior to hospitalization for community-acquired pneumonia is associated with decreased in-hospital mortality

Johnson, David H.; Carrière, Keumhee C.; Jin, Yan; Marrie, Thomas J.

doi:10.1111/j.1365-2710.2004.00553.x

Cited by 17 publications

(15 citation statements)

References 35 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous data suggest that appropriate antibiotic prescription prior to hospital admission is associated with reduced mortality in patients with community-acquired pneumonia [12,13]. However, we did not find such an association.…”

Section: Discussioncontrasting

confidence: 99%

“…However, this finding was not seen in another study [18]. Problems with these studies include small sample sizes [14-18], retrospective designs based on administrative records [11,12], and/or failure to use rigorous definition of CAP [18]. Accurate identification of pneumonia cases could be a problem especially in retrospective studies using administrative data (where up to 40% of all cases of pneumonia diagnosed by ER physicians were not confirmed as so by radiologists) [19].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of inhospital mortality and re-hospitalization in older adults with community-acquired pneumonia: a prospective cohort study

et al. 2010

View full text Add to dashboard Cite

BackgroundA better understanding of potentially modifiable predictors of in-hospital mortality and re-admission to the hospital following discharge may help to improve management of community-acquired pneumonia in older adults. We aimed to assess the associations of potentially modifiable factors with mortality and re-hospitalization in older adults hospitalized with community-acquired pneumonia.MethodsA prospective cohort study was conducted from July 2003 to April 2005 in two Canadian cities. Patients aged 65 years or older hospitalized for community-acquired pneumonia were followed up for up to 30 days from initial hospitalization for mortality and these patients who were discharged alive within 30 days of initial hospitalization were followed up to 90 days of initial hospitalization for re-hospitalization. Separate logistic regression analyses were performed identify the predictors of mortality and re-hospitalization.ResultsOf 717 enrolled patients hospitalized for community-acquired pneumonia, 49 (6.8%) died within 30 days of hospital admission. Among these patients, 526 were discharged alive within 30 days of hospitalization of whom 58 (11.2%) were re-hospitalized within 90 days of initial hospitalization. History of hip fracture (odds ratio (OR) = 4.00, 95% confidence interval (CI) = (1.46, 10.96), P = .007), chronic obstructive pulmonary disease (OR = 2.31, 95% CI = (1.18, 4.50), P = .014), cerebrovascular disease (OR = 2.11, 95% CI = (1.03, 4.31), P = .040) were associated with mortality. Male sex (OR = 2.35, 95% CI = (1.13, 4.85), P = .022) was associated with re-hospitalization while vitamin E supplementation was protective (OR = 0.37 (0.16, 0.90), P = .028). Lower socioeconomic status, prior influenza and pneumococcal vaccinations, appropriate antibiotic prescription upon admission, and lower nutrition risk were not significantly associated with mortality or re-hospitalization.ConclusionChronic comorbidities appear to be the most important predictors of death and re-hospitalization in older adults hospitalized with community-acquired pneumonia while vitamin E supplementation was protective.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of inhospital mortality and re-hospitalization in older adults with community-acquired pneumonia: a prospective cohort study

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Another factor that may influence the main outcomes in the steroid group is the higher prevalence of previous antibiotic use in these patients. Despite the practical difficulties involved in determining whether the previous antibiotic was appropriate according to microbial aetiology of pneumonia, different studies have reported that prior antimicrobial treatment is a protective factor for severe CAP (OR, 0.37; 95% confidence interval, 0.17–0.79; P = 0.009) . An early reduction in bacterial load or a coexisting anti‐inflammatory effect (i.e.…”

Section: Discussionmentioning

confidence: 99%

Systemic corticosteroids for community‐acquired pneumonia: Reasons for use and lack of benefit on outcome

Polverino

Cillóniz

Dambrava³

et al. 2013

Respirology

View full text Add to dashboard Cite

The main reasons for administering systemic steroids were the presence of chronic respiratory comorbidity or severe clinical presentation, but therapy did not influence mortality or clinical stability; by contrast, steroid administration was associated with prolonged length of stay. Nevertheless the steroid group did not show an increased mortality as it was expected according to the initial Pneumonia Severity Index score. Influence of steroids on outcomes of CAP need to be further investigated through randomized clinical trial.

show abstract

“…The increasing resistance of S. pneumoniae to these agents may be partially related to the phenomenon of serotype switch, to potentially more resistant serotypes such as 19A [4,6,16]. The increasing prevalence of such drug-resistance to existing first-line therapy poses a challenge because the therapy for CAP is often empiric (owing to the failure to identify the etiologic pathogen in many cases) and ineffective initial antimicrobial therapy has been associated with unfavorable economic and patient outcomes [17][18][19][20].…”

Section: Background and Rationalementioning

confidence: 99%

Ceftaroline fosamil for treatment of communityacquired pneumonia: findings from FOCUS 1 and 2 and potential role in therapy

DiMondi

Drew

Chen

2011

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

Cephalosporins have been widely used over the last few decades (often as first-line antibiotic therapy) for numerous infections, owing primarily to their broad spectrum of microbiologic activity and favorable safety profile. Current Infectious Diseases Society of America guidelines identify a third-generation cephalosporin in combination with a macrolide antibiotic as an option for treatment of hospitalized adult patients with community-acquired pneumonia (CAP) outside the intensive care unit setting. Although ceftriaxone is a frequently used agent for CAP, increasing incidence of multidrug-resistant Streptococcus pneumoniae and concerns regarding poor outcomes associated with ineffective therapy have prompted the search for a well-tolerated treatment alternative that is effective against bacteria that can cause CAP. Ceftaroline fosamil, the prodrug of ceftaroline, is a new extended-spectrum cephalosporin that exhibits time-dependant bactericidal activity against numerous Gram-negative and Gram-positive organisms, including methicillin-resistant Staphylococcus aureus and penicillin-resistant S. pneumoniae. Notable exceptions include Pseudomonas spp. and Gram-negative organisms that produce extended-spectrum β-lactamases or carbapenemases. Two large Phase III clinical trials (FOCUS 1 and 2) reported that ceftaroline fosamil was well tolerated, with a clinical cure rate of CAP that was noninferior to that with ceftriaxone in nonintensive care unit adult inpatients with moderately severe (Pneumonia Outcomes Research Team score of III or IV) community-acquired pneumonia.

show abstract

Appropriate antibiotic utilization in seniors prior to hospitalization for community-acquired pneumonia is associated with decreased in-hospital mortality

Abstract: Choosing an appropriate outpatient antibiotic in accordance with published expert opinion guidelines compared with inappropriate antibiotic prescriptions decreased hospital mortality in patients subsequently hospitalized for community-acquired pneumonia.

Cited by 17 publications

References 35 publications

Predictors of inhospital mortality and re-hospitalization in older adults with community-acquired pneumonia: a prospective cohort study

Predictors of inhospital mortality and re-hospitalization in older adults with community-acquired pneumonia: a prospective cohort study

Systemic corticosteroids for community‐acquired pneumonia: Reasons for use and lack of benefit on outcome

Ceftaroline fosamil for treatment of communityacquired pneumonia: findings from FOCUS 1 and 2 and potential role in therapy

Contact Info

Product

Resources

About