Antibiotic Therapy for Nearly 1 in 4 Adults with Pneumonia Does Not Work

Approximately 1 in 4 (22.1 percent) adults prescribed an antibiotic in an outpatient setting for community-acquired pneumonia does not respond to treatment, according to a new study presented at the 2017 American Thoracic Society International Conference | Infection Control Today

B0007348 Streptococcus pneumoniae

Image source: Debbie Marshall – Wellcome Images // CC BY 4.0

Image shows colour enhanced scanning electron micrograph of a colony of Streptococcus pneumoniae, the species of bacterium that is the commonest cause of pneumonia.

McKinnell and colleagues conducted this study because current community-acquired pneumonia guidelines from the American Thoracic Society and the Infectious Disease Society of America, published in 2007, provide some direction, but large-scale, real-world data are needed to better understand and optimize antibiotic choices and to better define clinical risk factors that may be associated with treatment failure.

The researchers examined databases containing records for 251,947 adult patients who were treated between 2011 and 2015 with a single class of antibiotics (beta-lactam, macrolide, tetracycline, or fluoroquinolone) following a visit to their physician for treatment for community-acquired pneumonia.  The scientists defined treatment failure as either the need to refill antibiotic prescriptions, antibiotic switch, ER visit or hospitalization within 30 days of receipt of the initial antibiotic prescription.  The total antibiotic failure rate was 22.1 percent, while patients with certain characteristics — such as older age, or having certain other diseases in addition to pneumonia — had higher rates of drug failure.  After adjusting for patient characteristics, the failure rates by class of antibiotic were:  beta-lactams (25.7 percent), macrolides (22.9 percent), tetracyclines (22.5 percent), and fluoroquinolones (20.8 percent).

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