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Case Fatality among Patients Hospitalized for Community-acquired Pneumonia according to Initial Antibiotic Treatment. A Comparison of Two Case Series

By Luis Alberto Corona Martínez, Iris González Morales, Pedro Luis Ocampo Miralles, Sandra Borroto Lecuna and Mercedes Corona Fonseca

Abstract

<strong>Background:</strong> community-acquired pneumonia is one of the major health problems worldwide and in the hospital of Cienfuegos.<br /><strong>Objective:</strong> to determine the changes in the relationship between the type of antimicrobial agent used empirically at admission and case fatality for community-acquired pneumonia in two case series designed at different times.<br /><strong>Methods:</strong> an observational, descriptive study was conducted to compare two case series of patients hospitalized due to the condition under study. The relationship between the antimicrobial agents selected (amoxicillin/sulbactam, cefuroxime, ceftriaxone and cefotaxime) and case fatality was analyzed taking into account potentially confounding variables. In the statistical analysis, the Chi-square test was used to compare the proportions, and Fisher's exact test was applied, with a 95% confidence level (p &lt;.05). <br /><strong>Results:</strong> in the two case series, the same pattern was observed in terms of the antimicrobial agents associated with the lowest and highest case fatality: cefuroxime and cefotaxime, respectively. In contrast to the A series, the B series showed a more uniform behavior of case fatality with the use of the antimicrobials selected, which meant a considerable reduction in case fatality among patients treated initially with third-generation cephalosporins in the B series. In this sense, the most significant impact on case fatality was observed in patients receiving ceftriaxone.<br /><strong>Conclusions:</strong> cefuroxime remains the initial empirical antimicrobial agent associated with the lowest case fatality among patients with community-acquired pneumonia. In the second case series, a clear reduction in case fatality was found in patients treated with ceftriaxone and cefotaxime.<br /><br /

Topics: infecciones comunitarias adquiridas, letalidad, antiinfecciosos, Medicine (General), R5-920, Medicine, R
Publisher: Centro Provincial de Información de las Ciencias Médicas en Cienfuegos
Year: 2016
OAI identifier: oai:doaj.org/article:502c19340ec044bcaaa06530ccfde05f
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