@article {ItoP4696, author = {Akihiro Ito and Tadashi Ishida and Hiromasa Tachibana and Akihiro Nishiyama and Kenjiro Furuta and Maki Tanaka and Fumiaki Tokioka and Hiroshige Yoshioka and Machiko Arita and Toru Hashimoto}, title = {Beta lactam plus macrolide antibiotic combination therapy reduces the mortality of community-acquired pneumococcal pneumonia more than beta lactam antibiotics alone}, volume = {44}, number = {Suppl 58}, elocation-id = {P4696}, year = {2014}, publisher = {European Respiratory Society}, abstract = {Background Some papers have reported that combination therapy with beta lactam and macrolide antibiotics (combination therapy) reduces the mortality of severe community-acquired pneumococcal pneumonia with bacteremia or that requiring mechanical ventilation more than therapy with beta lactam antibiotics alone (monotherapy). However, in Japan, the effect of macrolide antibiotics in pneumococcal pneumonia remains unclear.Objective To determine whether combination therapy is able to reduce mortality in patients with community-acquired pneumococcal pneumonia.Materials and methods The data of community-acquired pneumococcal pneumonia patients hospitalized in Kurashiki Central Hospital between February 2001 and November 2013 were analyzed. Patients{\textquoteright} charts were retrospectively analyzed to determine whether combination therapy reduced mortality in patients with community-acquired pneumococcal pneumonia more than monotherapy. The patients were divided into severe and non-severe pneumonia groups according to the ATS/IDSA criteria for severe pneumonia.Results A total of 539 patients (360 males, 179 females; mean age, 71.1 years) were studied. The mortality rates were 5.1\% (23/455) with monotherapy and 2.4\% (2/84) with combination therapy. In patients with severe pneumonia, the mortality rates were lower with combination therapy (8.7\%, 2/23) than with monotherapy (19.6\%, 21/107).Conclusion Severe pneumococcal pneumonia should be treated with beta lactam plus macrolide antibiotic combination therapy to achieve a better prognosis than with beta lactam monotherapy.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/44/Suppl_58/P4696}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }