Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia

被引：302

作者：

Baddour, LM

Yu, VL

Klugman, KP

Feldman, C

Ortqvist, A

Rello, J

Morris, AJ

Luna, CM

Snydman, DR

Ko, WC

Chedid, MBF

Hui, DS

Andremont, A

Chiou, CCC

机构：

[1] Mayo Clin, Rochester, NY USA

[2] Univ Pittsburgh, Div Infect Dis, Pittsburgh, PA 15260 USA

[3] Emory Univ, Rollins Sch Publ Hlth, Dept Int Hlth, Atlanta, GA 30322 USA

[4] Univ Witwatersrand, Resp & Meningeal Pathogens Res Unit, Johannesburg, South Africa

[5] Univ Witwatersrand, Johannesburg Hosp, MRC, Natl Hlth Lab Serv,Dept Med,Pulm Div, Johannesburg, South Africa

[6] Karolinska Inst, Karolinska Hosp, Dept Commun Dis Control & Prevent, S-10401 Stockholm, Sweden

[7] Univ Rovira & Virgili, Univ Hosp Joan 23, Tarragona, Spain

[8] Auckland Hosp, Clin Microbiol Lab, Auckland, New Zealand

[9] Univ Buenos Aires, Hosp Clin, Div Pulm Med, Buenos Aires, DF, Argentina

[10] Tufts Univ, New England Med Ctr, Sch Med, Div Geog Med & Infect Dis, Boston, MA 02111 USA

[11] Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med & Therapeut, Shatin, Hong Kong, Peoples R China

[12] Natl Cheng Kung Univ Hosp, Div Infect Dis, Tainan 70428, Taiwan

[13] Natl Yang Ming Univ, Vet Gen Hosp Kaohsiung, Dept Pediat, Taipei 112, Taiwan

[14] Univ Fed Rio Grande do Sul, Hosp Clin Porto ALegre, Postgrad Program Pulm, Porto Alegre, RS, Brazil

[15] Hop Bichat Claude Bernard, Asst Publ Hop Paris, Bacteriol Lab, F-75877 Paris 18, France

来源：

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE | 2004年 / 170卷 / 04期

关键词：

bacteremia; community-acquired pneumonia; Streptococcus pneumoniae;

D O I：

10.1164/rccm.200311-1578OC

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Retrospective studies have suggested that combination antibiotic therapy for severe bacteremic pneumococcal pneumonia may reduce mortality. We assessed this issue in a prospective, multicenter, international observational study of 844 adult patients with bacteremia due to Streptococcus pneumoniae. The effect of combination antibiotic therapy versus monotherapy on mortality was examined by univariate analyses and by logistic regression models. The 14-day mortality was not significantly different for the two groups. However, among critically ill patients, combination antibiotic therapy was associated with lower 14-day mortality (23.4 versus 55.3%, p = 0.0015). This improvement in survival was independent of country of origin, intensive care unit support, class of antibiotics, or in vitro activity of the antibiotics prescribed. Combination antibiotic therapy improved survival among critically ill patients with bacteremic pneumococcal illness.

引用

页码：440 / 444

页数：5

共 16 条

[1] PNEUMOCOCCAL BACTEREMIA WITH ESPECIAL REFERENCE TO BACTEREMIC PNEUMOCOCCAL PNEUMONIA [J].