Table 7.
Initial antibiotics treatment and clinical outcomes of all patients hospitalized with community-acquired pneumonia (CAP) and patients with severe CAP
| Initial antibiotics treatment | All Patients | Severe CAP | ||||
|---|---|---|---|---|---|---|
| Favorable Outcome† (n = 63) |
Unfavorable Outcome† (n = 31) |
p-value | Favorable Outcome† (n = 25) |
Unfavorable Outcome† (n = 25) |
p-value | |
| Antibiotic classes: | ||||||
| Nonantipseudomonas β-lactams | 37 (58.7) | 15 (48.4) | .38 | 14 (56) | 12 (48) | .57 |
| Antipseudomonas β-lactams | 15 (23.8) | 12 (38.7) | .13 | 8 (32) | 10 (40) | .56 |
| Macrolide (M) | 35 (55.6) | 10 (32.3) | .03* | 16 (64) | 7 (28) | .01* |
| Quinolone (Q) | 10 (15.9) | 6 (19.3) | .67 | 2 (8) | 5 (20) | .42 |
| Combination therapy | 39 (61.9) | 18 (58.1) | .72 | 16 (64) | 14 (56) | .56 |
| Guideline-concordant treatmenta | 42 (66.7) | 12 (38.7) | .01* | 16 (64) | 8 (32) | .02* |
| Guideline discordant treatment:a | 21 (33.3) | 19 (61.3) | .01* | 9 (36) | 17 (68) | .02* |
| β-lactams without Q or M: | 18 (28.6) | 15 (48.4) | 7 (28) | 13 (52) | ||
| Nonantipseudomonas β-lactams without Q or M | 5 (7.9) | 4 (12.9) | 0 | 4 (16) | ||
| Antipseudomonas β-lactams without Q or M | 13 (20.6) | 11 (35.5) | 7 (28) | 9 (36) | ||
| Q without β-lactams | 1 (1.6) | 4 (12.9) | 1 (4) | 4 (16) | ||
| M without β-lactams | 2 (3.2) | 0 | 1 (4) | 0 | ||
| Inadequate initial antibiotic treatmentb | 7 (11.1) | 4 (12.9) | 1 | 5 (20) | 4 (16) | 1 |
| Initial antibiotic regimen was modified | 13 (20.6) | 24 (77.4) | <.001* | 7 (28) | 19 (76) | .001* |
| Length of stay in hospital, dc | 9.9 ± 8.9 | 20.2 ± 11.1 | .001* | 13.5 ± 12.9 | 20.1 ± 12.1 | .16 |
| Hospital-free day, dd | 20.6 ± 5.6 | 4.8 ± 7.5 | <.001* | 18 ± 7.1 | 5.2 ± 8 | <.001* |
Data are presented as mean ± SD or n (%), unless otherwise stated. †Unfavorable outcome includes treatment failure or death during hospital admission. aThe 2007 ATS/IDSA guidelines on the management of community-acquired pneumonia in adults7. bPathogens detected were not susceptible to the antibiotics administered within 24 h of presentation. cLength of stay in hospital in patients who survived to hospital discharge. dNumber of days from admission to day 30 that the patient was not admitted to the hospital. *Statistically significant difference