Severe community-acquired pneumonia in general medical wards: outcomes and impact of initial antibiotic selection

BMC Pulmonary Medicine

Table 4 Initial antibiotics treatment and clinical outcomes by severity of community-acquired pneumonia (CAP)

	All Patients (n = 94)	Severe CAP (n = 50)	Non-severe CAP (n = 44)	p-value
Etiological diagnosis	43 (45.7)	28 (56)	15 (34.1)	.03*
Positive blood culture	14 (14.9)	12 (24)	2 (4.5)	.008*
Potentially drug-resistance bacteria	21 (22.3)	13 (46.4)	8 (53.3)	.36
Combination therapy	57 (60.6)	30 (60)	27 (61.4)	.89
Guideline-concordant antibiotic therapy^a	54 (57.4)	24 (48)	30 (68.2)	.048*
Guideline- discordant antibiotic therapy:^a	40 (42.6)	26 (52)	14 (31.8)
β-lactams without quinolone or macrolide:	33 (35.1)	20 (40)	13 (29.5)
Nonantipseudomonas β-lactams without quinolone or macrolide	9 (9.6)	4 (8)	5 (11.4)
Antipseudomonas β-lactams without quinolone or macrolide	24 (25.5)	16 (32)	8 (18.2)
Quinolone without β-lactams	5 (5.3)	5 (10)	0
Macrolide without β-lactams	2 (2.1)	1 (2)	1 (2.3)
Inadequate initial antibiotic treatment^b	11/43 (25.6)	9/28 (32.1)	2/15 (13.3)	.28
Initial antibiotic regimen was modified	37 (39.4)	26 (52)	11 (25)	.008*
Treatment failure	27 (28.7)	23 (46)	4 (9.1)	<.001*
Death	18 (19.1)	14 (28)	4 (9.1)	.02*
Unfavorable outcome^c	31 (32.9)	25 (50)	6 (13.6)	<.001*
Hospital-free day, d^d	15.4 ± 9.8	11.6 ± 9.9	19.7 ± 7.7	<.001*

Data are presented as mean ± SD or n (%), unless otherwise stated. ^aThe 2007 ATS/IDSA guidelines on the management of community-acquired pneumonia in adults. ^bPathogens detected were not susceptible to the antibiotics administered within 24 h of presentation. ^cUnfavorable outcome includes treatment failure or death during hospital admission. ^dNumber of days from admission to day 30 that the patient was not admitted to the hospital. *Statistically significant difference

ISSN: 1471-2466