RT Journal Article
SR Electronic
T1 Difference of patient background with pneumonia between monotherapy and combination
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2563
VO 38
IS Suppl 55
A1 Masataka Shibasaki
A1 Mitsunori Nishikawa
A1 Yuichi Kitagawa
A1 Kazuyoshi Senda
A1 Kazumitsu Nakashima
A1 Fumihiro Mizokami
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2563.abstract
AB Background: The current guidelines recommend combination therapy of antibiotics empirically for pneumonia patients with risks of PDR pathogens. However, this recommendation remains controversial. [Aims and objectives] To elucidate factors which may lead physicians to select combination therapy of antibiotics for pneumonia.Materials: Pneumonia patients who were admitted to National Center for Geriatrics and Gerontology Hospital from April 2008 to December 2009, and treated with carbapenem (A group, n=70) or combination of carbapenem+aminoglycosides (B group, n=68).Methods: Information on age, gender, weight, risk factors of PDR pathogens, pneumonia type (CAP/HCAP/HAP), Barthel index, clinical response, duration of therapy and 30-day mortality were obtained from chart review. We compared the aforementioned factors between two groups using multiple logistic regression analysis.Results: There were significant differences about the aforementioned factors except age between A and B group in univariate analysis. However, in multivariate logistic regression analysis, only Barthel index was significantly different between both groups (81.8±29.2 in A group vs. 59.1±40.3 in B group, P<0.01, respectively). The clinical efficacy rates were 79% in A and 63% in B groups, respectively. The 30-day mortalities were 13% in A and 38% in B groups, respectively (P=0.067). Duration of antibiotics therapy was significantly shorter in A group compared with B group (7.3±4.7 vs. 19.3±8.2 days, respectively, P<0.01).Conclusion: Barthel index was the independent factor which affected physicians to select combination therapy of antibiotics.