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Influence of comorbidity and severity on the clinical outcome of bacteremic pneumococcal pneumonia treated with beta-lactam monotherapy.


J Chemother. 1999 Aug;11(4):266-72. Unique Identifier : AIDSLINE

The influence of the severity of pneumonia and comorbidity factors, as predictors of clinical outcome, was assessed in patients with microbiologically documented pneumococcal bacteremic pneumonia treated with penicillin or third generation cephalosporin monotherapy in a 5-year retrospective study. Among 288 patients admitted to three Spanish hospitals with bacteremic pneumococcal pneumonia, 65 (23%) were included. Twenty-four were treated with penicillins and 41 with a third-generation cephalosporin. Twenty-seven patients (42%) had severe pneumonia and 41 (63%) had a comorbidity index >1. Twenty-one patients (32%) were infected with penicillin-resistant strains. Four cases (2 with penicillin-resistant strains; 3 treated with cephalosporins) were clinical failures. Four cases (3 with penicillin-resistant strains; 2 treated with cephalosporins) died, i.e. 6% mortality rate. The only factor that influenced empirical treatment election was HIV-positive condition. Clinical outcome was not influenced by treatment election, penicillin susceptibility of the infecting pneumococci, patient basal conditions or severity of pneumonia, but the latter was associated with mortality and length of hospitalization.

JOURNAL ARTICLE Adolescence Adult Aged Cephalosporins/*THERAPEUTIC USE Child Child, Preschool Comorbidity Female Human HIV Infections Length of Stay Male Middle Age Penicillin Resistance Penicillins/PHARMACOLOGY/*THERAPEUTIC USE Pneumonia, Pneumococcal/*DRUG THERAPY/MORTALITY/PATHOLOGY Prognosis Retrospective Studies Streptococcus pneumoniae/*PATHOGENICITY Support, Non-U.S. Gov't Treatment Outcome


Information in this article was accurate in December 30, 1999. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.