Prospective study of epidemiology and prognostic factors in community-acquired pneumonia

Abstract

Of 342 patients with community-acquired pneumonia, 100 were diagnosed etiologically. In these patients, disease epidemiology, prognostic factors, and influence of antibiotic treatment were analyzed prospectively. Fifty-two patients were treated with a broad-spectrum antibiotic (ceftriaxone), and 48 received a medium-spectrum antibiotic (cefuroxime); some patients in each group also received erythromycin. Streptococcus pneumoniae was the most frequently isolated microorganism (43%), followed by Chlamydia pneumoniae (21%), Haemophilus influenzae (19%), and Mycoplasma pneumoniae (11%). Factors significantly associated with increased mortality were initially critical or poor clinical condition, involvement of two or more lobules, and complications. Prior administration of antibiotics was predictive of penicillin and erythromycin resistance in Streptococcus pneumoniae, but had no effect on the course of the disease. Eight patients died, 89 were cured, and three had recurrences; there was no significant difference in outcome between treatment groups, regardless of whether patients also received erythromycin. Increased knowledge of epidemiological, predictive, and prognostic factors can significantly improve early diagnosis of community-acquired pneumonia and facilitate the choice of appropriate antibiotic treatment, thereby helping to reduce morbidity and mortality.

Guidelines for the management of adult lower respiratory tract infections

“…In a second step, the selection of antimicrobial treatment can follow general patterns of expected pathogens according to pneumonia severity and additional risk factors [41,60,61,[127][128][129][130][131][132].…”

Criteria for clinical stability in hospitalised patients with community-acquired pneumonia

“…MENÉ NDEZ et al [14] found that low levels of CRP and PCT, in addition to clinical criteria, seem to increase the likelihood of an absence of severe complications in hospitalised patients with CAP. Furthermore, repeat measurements of CRP after 72 or 96 h from initiation of antibiotic therapy seem to be helpful in identifying patients with treatment failure [15,16]. Future research is needed to define if the Data are presented as n (%).…”

Dihydrostreptomycin or streptomycin in combination with penicillin G in dairy cattle therapeutics: A review and re-analysis of published data Part 2: Resistance and residues

“…Especially with oral use at sub-therapeutic concentrations, antimicrobial drugs rapidly lead to multiple drug resistance amongst enteric commensal microfiora (6). Prevalence of exposure to antimicrobial drugs has been iden tified as a predictor of the development of antibiotic drug resistance (7) and it is now generally accepted that the contin ued use of an antimicrobial drug will lead to an increase in prevalence of drug resistance, not only to that drug but also to others which frequently share a transmissible R-plasmid.…”