Table 7.
Clinical outcomes and hospital resource use for patients with and without antibiotic pre-treatment
|
Outcome, n (%) |
Early responders n = 332 |
Later responders n = 253 |
||
|---|---|---|---|---|
| Without antibiotic pre-treatment n = 266 | With antibiotic pre-treatment n = 61 | Without antibiotic pre-treatment n = 184 | With antibiotic pre-treatment n = 58 | |
| Antibiotic treatment modification while on initial therapy (excluding streamlining*) |
38 (14.3) |
7 (11.5) |
66 (35.9) |
20 (34.5) |
| Time to clinical stability, days, mean (SD) [median] based on Halm's criteria |
2.6 (1.0) [2.0] |
2.8 (0.9) [3.0] |
9.2 (7.0) [7.0] |
8.5 (5.7) [7.0] |
| Length of stay†, days, mean (SD) [median] |
10.1 (7.7) [8.0] |
8.6 (4.5) [7.0] |
17.0 (12.6) [13.0] |
15.3 (9.9) [12.0] |
| Patients admitted to ICU |
9 (3.4) |
2 (3.3) |
44 (23.9) |
9 (15.5) |
| Time in ICU‡, days mean (SD) [median] (n) |
6.3 (6.3) [4.0] (n = 9) |
5.5 (2.1) [5.5] (n = 2) |
10.8 (10.9) [8.0] (n = 44) |
8.9 (4.3) [9.0] (n = 8) |
| Reinfection/recurrence§ |
9 (3.4) |
2 (3.3) |
10 (5.4) |
5 (8.6) |
| Home-based care after discharge |
6 (2.3) |
0 |
9 (4.9) |
2 (3.4) |
| Blood pressure support during hospitalization |
|
|
|
|
| Fluid resuscitation |
19 (7.1) |
4 (6.6) |
26 (14.1) |
9 (15.5) |
| Vasopressors |
2 (0.8) |
0 |
12 (6.5) |
5 (8.6) |
| Invasive procedures |
0 |
1 (1.6) |
3 (1.6) |
0 |
| Isolation required |
24 (9.0) |
3 (4.9) |
17 (9.2) |
7 (12.1) |
| Mechanical ventilation required during hospitalization |
23 (8.6) |
1 (1.6) |
40 (21.7) |
7 (12.1) |
| Invasive |
12 (4.5) |
0 |
22 (12.0) |
5 (8.6) |
| Non-invasive |
11 (4.1) |
1 (1.6) |
23 (12.5) |
2 (3.4) |
| Parenteral nutrition |
4 (1.5) |
1 (1.6) |
17 (9.2) |
1 (1.7) |
| Duration of parenteral nutrition, days, mean (SD) [median] |
4.5 (1.0) [5.0] |
12.0 (-) [12.0] |
8.6 (5.3) [7.0] |
3.0 (-) [3.0] |
| Acute renal failure necessitating renal replacement therapy |
1 (0.4) |
0 |
5 (2.7) |
1 (1.7) |
| Duration of renal failure, days, mean (SD) [median] |
2.0 (-) [2.0] |
- |
14.3 (16.0) [9.5] |
- |
| Septic shock during hospitalization |
1 (0.4) |
0 |
15 (8.2) |
5 (8.6) |
| Mortality | 2 (0.8) | 0 | 1 (0.5) | 3 (5.2) |
*De-escalation of treatment to narrower-spectrum antibiotics upon patient improvement or confirmed microbiological diagnosis.
†Includes duration of all hospitalizations for patients with recurrences.
‡Does not include duration of all hospitalizations for patients with recurrences.
§Refers to patients hospitalized again (due to CAP) after initial discharge.
ICU = intensive care unit; SD = standard deviation.