Is gentamicin safe and effective for severe community-acquired pneumonia? An 8-year retrospective cohort study

Brereton, Christopher J.; Lennon, D. J.; Browning, Sarah; Dunn, Emily F.; Ferguson, John; Davis, Joshua S.

doi:10.1016/j.ijantimicag.2018.01.018

Cited by 6 publications

(7 citation statements)

References 22 publications

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“…While some studies have included both outpatient and inpatient claims to identify hip fractures, and have also included contiguous fractures (e.g., pelvic fractures), we opted against this approach for several reasons: 1) 90%-95% of all hip fracture events will be captured in the inpatient file 27 ; 2) nonoperative outpatient management of hip fractures are rare in community-dwelling older adults and usually reserved for those at the very end of life; and 3) we sought a uniform definition of hip fracture based on prior work. 4,5,8,9,29 Pneumonia: Guided by prior algorithms, [30][31][32] we defined pneumonia using ICD-9 and ICD-10 diagnostic codes in the Medicare inpatient claims file (see Table S1 for full list). We included ICD codes in any position in the claims and applied a 30-day period to define a single pneumonia event.…”

Section: Discussionmentioning

confidence: 99%

Incidence of potentially disruptive medical and social events in older adults with and without dementia

Hunt

Gan

Espejo

et al. 2022

J American Geriatrics Society

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Background Potentially disruptive medical, surgical, and social events—such as pneumonia, hip fracture, and widowhood—may accelerate the trajectory of decline and impact caregiving needs in older adults, especially among people with dementia (PWD). Prior research has focused primarily on nursing home residents with dementia. We sought to assess the incidence of potentially disruptive events in community‐dwelling people with and without dementia. Methods Retrospective cohort study of participants aged 65+ enrolled in the Health and Retirement Study between 2010 and 2018 (n = 9346), including a subset who were married–partnered at baseline (n = 5105). Dementia was defined with a previously validated algorithm. We calculated age‐adjusted and gender‐stratified incidence per 1000 person‐years and incidence rate ratios of: 1) hospitalization for pneumonia, 2) hip fracture, and 3) widowhood in people with and without dementia. Results PWD (n = 596) were older (mean age 84 vs. 75) and a higher proportion were female (67% vs. 57%) than people without dementia (PWoD) (n = 8750). Age‐adjusted incidence rates (per 1000 person‐years) of pneumonia were higher in PWD (113.1; 95% CI 94.3, 131.9) compared to PWoD (62.1; 95% CI 54.7, 69.5), as were hip fractures (12.3; 95% CI 9.1, 15.6 for PWD compared to 8.1; 95% CI 6.9, 9.2 in PWoD). Point estimates of widowhood incidence were slightly higher for PWD (25.3; 95% CI 20.1, 30.5) compared to PWoD (21.9; 95% CI 20.3, 23.5), but differences were not statistically significant. The association of dementia with hip fracture—but not pneumonia or widowhood—was modified by gender (male incidence rate ratio [IRR] 2.24, 95% CI 1.34, 3.75 versus female IRR 1.31 95% CI 0.92,1.86); interaction term p = 0.02). Conclusions Compared to PWoD, community‐dwelling PWD had higher rates of pneumonia and hip fracture, but not widowhood. Knowing how often PWD experience these events can aid in anticipatory guidance and care planning for this growing population.

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Section: Discussionmentioning

confidence: 99%

Incidence of potentially disruptive medical and social events in older adults with and without dementia

Hunt

Gan

Espejo

et al. 2022

J American Geriatrics Society

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“…However, when used for a maximum of 48-72 h (the usual duration of empiric therapy until microbiology results are available), the risk of nephrotoxicity and ototoxicity are both low. 9 Vancomycin can also be nephrotoxic, and this risk is decreased with shorter courses, weight-based dosing, and therapeutic drug monitoring if it is used for >48-72 h. If this risk is considered too great, alternatives to vancomycin include daptomycin or ceftaroline.…”

Section: Empiric Antibiotic Therapy For Pjimentioning

confidence: 99%

“…Of these three options, gentamicin is the cheapest, most likely to be active and least likely to select for multi‐resistant organisms or Clostridium difficile , but it also has the highest potential for toxicity. However, when used for a maximum of 48–72 h (the usual duration of empiric therapy until microbiology results are available), the risk of nephrotoxicity and ototoxicity are both low 9 . Vancomycin can also be nephrotoxic, and this risk is decreased with shorter courses, weight‐based dosing, and therapeutic drug monitoring if it is used for >48–72 h. If this risk is considered too great, alternatives to vancomycin include daptomycin or ceftaroline.…”

Section: Early Post‐operative (N = 169) Late Acute (N = 314) Chronic ...mentioning

confidence: 99%

Proposed empiric antibiotic therapy for prosthetic joint infections: an analysis of the Prosthetic Joint Infection in Australia and New Zealand, Observational (PIANO) cohort

Davis

Metcalf

Paterson

et al. 2022

Internal Medicine Journal

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Empiric antibiotic therapy in suspected prosthetic joint infection should cover likely pathogens while avoiding overly broad‐spectrum antibiotics. We analysed individual patient data from a large prospective cohort study (Prosthetic Joint Infection in Australia and New Zealand, Observational (PIANO)) and found that causative organisms vary with the presentation type, with early post‐operative infections more likely to be polymicrobial (41%) compared with late acute infections (10%). We thus propose empirical regimens tailored to the presentation type and presence or absence of sepsis.

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“…Gentamisin menembus dengan baik ke dalam cairan lapisan alveolar dan efektif melawan hampir semua patogen gram negatif penyebab pneumonia komunitas. Hasil penelitian lain menunjukkan bahwa gentamisin sama amannya dan efektif sebagai alternatif antibiotika gram negatif pada terapi empiris awal pengobatan orang dewasa dengan pneumonia komunitas parah (Brereton et al, 2018).…”

Section: Hasil Dan Pembahasanunclassified

ASSOCIATION OF APPROPRIATNESS ANTIBIOTIC PRESCRIPTION WITH CLINICAL IMPROVEMENT IN CAP BASED ON Pharmaceutical Care Network Europe (PCNE)

Kurniawati

Perwitasari

Risdiana³

2021

Media Farmasi

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Is gentamicin safe and effective for severe community-acquired pneumonia? An 8-year retrospective cohort study

Cited by 6 publications

References 22 publications

Incidence of potentially disruptive medical and social events in older adults with and without dementia

Incidence of potentially disruptive medical and social events in older adults with and without dementia

Proposed empiric antibiotic therapy for prosthetic joint infections: an analysis of the Prosthetic Joint Infection in Australia and New Zealand, Observational (PIANO) cohort

ASSOCIATION OF APPROPRIATNESS ANTIBIOTIC PRESCRIPTION WITH CLINICAL IMPROVEMENT IN CAP BASED ON Pharmaceutical Care Network Europe (PCNE)

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