Adverse hospital outcomes associated with the choice of empiric antibiotics in Klebsiella pneumoniae pneumonia: a retrospective observational study.
Ann Acad Med Singap
; 36(8): 642-6, 2007 Aug.
Article
en En
| MEDLINE
| ID: mdl-17767334
ABSTRACT
INTRODUCTION:
In Malaysia, Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalisation. PATIENTS ANDMETHODS:
With concern over its rising microbial resistance, we explored the association of empiric antibiotics choices with the hospital outcomes of patients treated for microbial proven K. pneumoniae pneumonia in an urban-based teaching hospital.RESULTS:
In 313 eligible cases reviewed retrospectively, hospital mortality and requirement for ventilation were 14.3% and 10.8% respectively. Empiric regimes that had in vitro resistance to at least one empiric antibiotic (n = 90) were associated with higher hospital mortality (23.3% vs. 10.8%, P = 0.004) with risk increased by about two-fold [Odds ratio (OR), 2.5; 95% confidence interval (CI), 1.3 to 4.8]. Regimes (n = 84) other than the commonly recommended "standard" regimes (a beta-lactam stable antibiotic with or without a acrolide) were associated with higher ventilation rates (16.7% vs. 8.8%, P = 0.047) with similar increased risk [OR, 2.0; 95% CI, 1.0 to 4.3].CONCLUSIONS:
Our findings reiterate the clinical relevance of in vitro microbial resistance in adult K. pneumoniae pneumonia and support empiric regimes that contain beta-lactam stable antibiotics.
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Banco de datos:
MEDLINE
Asunto principal:
Infecciones por Klebsiella
/
Pacientes Internos
/
Klebsiella pneumoniae
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
País como asunto:
Asia
Idioma:
En
Año:
2007
Tipo del documento:
Article