Table 2—

Univariate analysis relative to 30-day mortality

VariablesCases n% (95% CI)HR (95% CI )p-value#
Antibiotics
 β-Lactams+macrolides19831 (27.4–34.6)1
  Macrolides+
   Second GCS16
   Third GCS156
   Fourth GCS7
  β-Lactam/β-lactamase inhibitor14
  Imipenem3
  Others2
 β-Lactams25139.3 (35.6–43.1)0.66 (0.39–1.10)0.114
  Second GCS25
  Third GCS86
  Fourth GCS9
  β-Lactam/β-lactamase inhibitor106
  Imipenem3
  Others42
 Macrolides375.8 (4.1–7.9)0.15 (0.02–1.13)0.065
 Levofloxacine487.5 (5.6–9.8)0.24 (0.06–1.03)0.054
  Alone38
  Combination+10
 Other combinations10416.3 (13.4–19.2)2.16 (1.31–3.55)0.002<0.001
  Second/third/fourth GCS+ aminoglycoside16
  Any β-lactam+macrolide+aminoglycoside6
  Aminoglycosides11
  Antibiotic combinations including
   Vancomycin5
   Other66
Suspected aspiration518 (6.0–10.4)4.35 (2.69–7.03)<0.001
Alcohol§14422.6 (19.3–25.8)1.60 (1.03–2.48)0.037
Bilateral pneumonia9915.5 (12.7–18.3)2.95 (1.91–4.56)<0.001
Change in treatmentƒ10716.8 (13.9–19.7)2.26 (1.46–3.51)<0.001
PSI score
 I+II+III25740.3 (36.5–44.1)1
 IV23436.7 (32.9–40.4)3.77 (1.86–7.68)<0.001
 V14723.0 (19.8–26.3)10.36 (5.25–20.43)<0.001<0.001
ICU admission12519.6 (16.5–22.7)3.52 (2.33–5.31)<0.001
Shock##10216.0 (13.1–18.8)13.56 (8.81–20.87)<0.001
Tobacco¶¶37759.1 (55.3–62.9)0.67 (0.45–1.01)0.056
Chronic pulmonary disease++25439.8 (36.0–43.6)0.59 (0.38–0.93)0.023
HIV infection§§619.6 (7.4–12.1)1.70 (0.95–3.06)0.076
Polymicrobial pneumoniaƒƒ345.3 (3.7–7.8)1.74 (0.84–3.59)0.135
Adequacy of treatment###
 Concordant56087.8 (85.2–90.3)1
 Discordant type 1375.8 (4.1–7.9)1.35 (0.62–2.93)0.448
 Discordant type 2416.4 (4.6–8.6)1.70 (0.85–3.39)0.1340.268
Penicillin susceptibility
 Sensitive40964.1 (60.4–67.8)1
 Intermediate16425.7 (22.3–29.1)1.46 (0.93–2.30)0.100
 Resistant6510.2 (7.8–12.5)1.55 (0.82–2.91)0.1750.165
Typical symptomatology¶¶¶10616.6 (13.7–19.5)2.09 (1.32–3.32)0.002
Renal failure+++12719.9 (16.8–23)5.06 (3.36–7.62)<0.001
Bacteraemia42967.2 (63.6–70.9)1.03 (0.67–1.59)0.898
Serotype
 A§§§14222.3 (19.0–25.5)1
 Bƒƒƒ42867.1 (63.4–70.7)90330 (0)0.846
 C####6810.7 (8.3–13.1)159235 (0)0.8380.087
  • 95% CI: 95% confidence interval; HR: hazard ratio; GCS: generation cephalosporin; PSI: pneumonia severity index 23; ICU: intensive care unit. #: For those variables with several categories the first column of p-values compares every category of the variable to reference category, assigning a p-value of 1 to the reference category. The second column shows the significance of the variable as a whole. : Erythromycin, clarithromycin or azithromycin. +: Third and fourth GCS (n = 4) or other (n = 6). §: Estimated daily consumption of >80 g of alcohol for at least the preceding year. ƒ: Modifications in the route of administration and/or step-down therapy were not considered as a change in antimicrobial therapy. ##: Blood pressure ≤90 mmHg not corrected by i.v. fluids, or requiring pressor medication. ¶¶: Smokers were defined as current smokers even if they had quit <6 months before the beginning of the study. ++: Chronic obstructive pulmonary disease, chronic bronchitis, bronchiectasis and chronic pulmonary conditions other than asthma. §§: Infection by HIV was recovered of the previous chart information and by the data on admittance. ƒƒ: Mixed infections were established when another likely microorganism was identified along with at least one of the following: 1) At least a four-fold increase in immunoglobulin G titres for Chlamydophila pneumoniae, Legionella pneumophila, Coxiella burnetii, Mycoplasma pneumoniae, and respiratory viruses; 2) positive urinary antigen for L. pneumophila; 3) identification of other bacterial pathogen according to standard methods in samples other than sputum or bronchial aspirate. ###: Antibiotic treatment was considered concordant if at least one antibiotic, administered during the first 48 h after the specimen was obtained for culture, showed full in vitro sensitivity (neither intermediate nor resistant) against the isolated strains. Therapies without this criterion were defined as discordant and classified as either type 1, when pneumococcal strains showed intermediate susceptibility to the administered therapy, or type 2, when the infection was caused by pneumococcal strains resistant to the administered regimen. ¶¶¶: When at least three of the following were present: cough, expectoration, pleuritic pain, fever and onset or increase of dyspnoea. +++: Serum creatinine>1.5 mg·dL−1 and/or blood urea nitrogen>20 mg·dL−1 in previously normal patients. §§§: Serotypes 1, 5, 8, 10, 13, 17, 18A, 18F, 20, 23F, 25, 34, 37, 38, 42 showed no mortality. ƒƒƒ: Serotypes 3, 4, 6A, 6B, 7, 9N, 9V, 11, 12, 14, 15A, 15F, 16, 18C, 22, 23A, 23B, 31, 33, 35, NT had a mortality rate of 17%. ####: Serotype 19 pneumococcal isolate had a mortality rate of 27.6% 17.