Table 3.
Antibiotic Treatments and Clinical Outcomes in Patients with HCAP and CAPa
| Treatment | HCAP (n = 231) |
CAP (n = 296) |
P-value |
|---|---|---|---|
| Inappropriate antibiotic therapyb | 27/73 (37.0) | 19/78 (24.4) | 0.092 |
| Monotherapy | 30 (13.0) | 53 (17.9) | 0.124 |
| Amino-penicillins | 3 (1.3) | 5 (1.7) | - |
| Cephalosporin | 5 (2.2) | 8 (2.7) | - |
| Antipseudomonal penicillins | 6 (2.6) | 6 (2.0) | - |
| Fluroquinolone | 13 (5.6) | 34 (11.5) | - |
| Carbapenem | 3 (1.3) | 0 (0) | - |
| Combination therapy | 201 (87.0) | 243 (82.1) | 0.124 |
| β-lactams + fluoroquinolone | 4 (1.7) | 8 (2.7) | - |
| β-lactams + macrolide | 36 (15.6) | 112 (37.8) | <0.001 |
| β-lactams + clindamycin | 10 (4.3) | 14 (4.7) | - |
| β-lactams + aminoglycoside | 6 (2.6) | 1 (0.3) | - |
| Fluoroquinolone + clindamycin | 13 (5.6) | 12 (4.1) | - |
| Antipseudomonal β-lactams + fluroquinolone | 63 (27.3) | 48 (16.2) | 0.001 |
| Antipseudomonal β-lactams + macrolide | 0 (0) | 1 (0.3) | - |
| Antipseudomonal β-lactams + clindamycin | 6 (2.6) | 3 (1.0) | - |
| Antipseudomonal β-lactams + aminoglycoside | 8 (3.5) | 2 (0.7) | - |
| Other combination therapyc | 55 (23.8) | 42 (14.2) | 0.002 |
| Clinical outcomes | |||
| In-hospital mortality | 65 (28.1) | 32 (10.8) | <0.001 |
| Early treatment failured | 56 (24.2) | 37 (12.5) | <0.001 |
| ICU admission | 49 (21.2) | 37 (12.5) | 0.007 |
| ICU mortality | 31 (13.4) | 21 (7.1) | 0.016 |
| Need for mechanical ventilation | 47 (20.3) | 39 (13.2) | 0.027 |
| Duration of hospital stay (days) | 18.6 ± 19.1 | 12.9 ± 13.1 | <0.001 |
a Data are presented as numbers (percentages) unless otherwise indicated. Plus-minus values are means ± standard deviation.
b Number of patients/total number of patients whose causative pathogens and antibiotic sensitivity test results are known (percentages). Results of antibiotics sensitivity test were not available in six patients with HCAP and five patients with CAP.
c Others contain combination therapy of three or more drugs, including aminopenicillins, cephalosporin, antipseudomonal penicillin, aminglycoside, macrolide, clindamycin, fluoroquinolone, glycopeptide, trimethoprim/sulfamethoxazole, and antifungal agent.
d Early treatment failure was defined as clinical deterioration within 72 h of treatment such as lack of response or worsening of fever, respiratory condition, and/or radiographic status requiring mechanical ventilation, aggressive fluid resuscitation or vasopressors, or death
HCAP healthcare-associated pneumonia
CAP community-acquired pneumonia
ICU intensive care unit