Outcomes of Health Care–Associated Pneumonia Empirically Treated with Guideline-Concordant Regimens Versus Community-Acquired Pneumonia Guideline–Concordant Regimens for Patients Admitted to Acute Care Wards from Home

Abstract

Compared to CAP guideline-concordant regimens, treatment of HCAP with HCAP guideline-concordant regimens did not increase clinical cure rates and was associated with lower clinical cure rates in patients hospitalized 31-90 days prior to the HCAP admission. This study suggests that broad-spectrum empiric antibiotics may not be necessary in all HCAP patient groups.

Predicting risk of drug-resistant organisms in pneumonia: Moving beyond the HCAP model

“…This was confirmed in a meta-analysis by Chalmers et al who showed no difference in mortality between CAP and HCAP when adjusted for age and co-morbidity [5,38]. Second, unnecessary extended-spectrum antibiotic therapy increases cost [20,32], drug toxicity [39e41], Clostridium difficile infection [42], and antibiotic resistance [43], which may affect outcomes.…”

Advances in the causes and management of community acquired pneumonia in adults

“…[88][89][90][91][92][93][94][95][96] Clinicians must be aware of their local ecology and whether studies id entifying risk low. The trial failed to show that monotherapy was noninferior in terms of time to clinical stability; only 34% (97/289) of monotherapy patients had reached clinical stability at day seven of therapy compared with 41% (120/291) for combination therapy, with the upper limit of the one sided 95% confidence interval (13%) exceeding the pre-specified boundary of 8%.…”

Derivation and Multicenter Validation of the Drug Resistance in Pneumonia Clinical Prediction Score

“…This may be in part due to the poor ability of the HCAP criteria to predict pneumonia due to DRPs (15)(16)(17). The unnecessary use of extended-spectrum antibiotics is associated with negative collateral effects, including increased costs (12,18) and lengths of stay (12,19,20), drug toxicity (21)(22)(23)(24), Clostridium difficile infection (25), and resistance (26).…”