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. 1974 May 18;2(5915):359–362. doi: 10.1136/bmj.2.5915.359

Secondary Respiratory Infection in Hospital Patients: Effect of Antimicrobial Agents and Environment

J R Philp, R C Spencer
PMCID: PMC1610232  PMID: 4209815

Abstract

A prospective study of 358 medical and 234 postoperative patients with clinical evidence of secondary chest infection showed that previous administration of antimicrobial agents greatly reduced the chance of obtaining a clear-cut laboratory report. In patients with radiographical evidence of pneumonia this led to a fourfold decrease in the overall rate of isolation of potential pathogens. Furthermore, 81 diverse “coliforms” were isolated from 258 medical and surgical patients who had received previous antimicrobial therapy while only four coliforms (all Escherichia coli) were isolated from 334 untreated patients. Thus the general hospital environment on its own seemed to have a negligible influence in promoting the growth of coliform flora in sputum. Any unique effect of underlying disease in this regard was masked by that of previous therapy. Finally, the results raised the possibility that previous antimicrobial therapy might have increased the risk of secondary pneumonia in hospital patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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