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Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study.
Thorax. 2005 Aug; 60(8):672-8.T

Abstract

BACKGROUND

There is much controversy about the ideal approach to the management of community acquired pneumonia (CAP). Recommendations differ from a pathogen directed approach to an empirical strategy with broad spectrum antibiotics.

METHODS

In a prospective randomised open study performed between 1998 and 2000, a pathogen directed treatment (PDT) approach was compared with an empirical broad spectrum antibiotic treatment (EAT) strategy according to the ATS guidelines of 1993 in 262 hospitalised patients with CAP. Clinical efficacy was primarily determined by the length of hospital stay (LOS). Secondary outcome parameters for clinical efficacy were assessment of therapeutic failure on antibiotics, 30 day mortality, duration of antibiotic treatment, resolution of fever, side effects, and quality of life.

RESULTS

Three hundred and three patients were enrolled in the study; 41 were excluded, leaving 262 with results available for analysis. No significant differences were found between the two treatment groups in LOS, 30 day mortality, clinical failure, or resolution of fever. Side effects, although they did not have a significant influence on the outcome parameters, occurred more frequently in patients in the EAT group than in those in the PDT group (60% v 17%, 95% CI -0.5 to -0.3; p<0.001).

CONCLUSIONS

An EAT strategy with broad spectrum antibiotics for the management of hospitalised patients with CAP has comparable clinical efficacy to a PDT approach.

Authors+Show Affiliations

Department of Pulmonary Diseases, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16061709

Citation

van der Eerden, M M., et al. "Comparison Between Pathogen Directed Antibiotic Treatment and Empirical Broad Spectrum Antibiotic Treatment in Patients With Community Acquired Pneumonia: a Prospective Randomised Study." Thorax, vol. 60, no. 8, 2005, pp. 672-8.
van der Eerden MM, Vlaspolder F, de Graaff CS, et al. Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study. Thorax. 2005;60(8):672-8.
van der Eerden, M. M., Vlaspolder, F., de Graaff, C. S., Groot, T., Bronsveld, W., Jansen, H. M., & Boersma, W. G. (2005). Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study. Thorax, 60(8), 672-8.
van der Eerden MM, et al. Comparison Between Pathogen Directed Antibiotic Treatment and Empirical Broad Spectrum Antibiotic Treatment in Patients With Community Acquired Pneumonia: a Prospective Randomised Study. Thorax. 2005;60(8):672-8. PubMed PMID: 16061709.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study. AU - van der Eerden,M M, AU - Vlaspolder,F, AU - de Graaff,C S, AU - Groot,T, AU - Bronsveld,W, AU - Jansen,H M, AU - Boersma,W G, PY - 2005/8/3/pubmed PY - 2005/9/13/medline PY - 2005/8/3/entrez SP - 672 EP - 8 JF - Thorax JO - Thorax VL - 60 IS - 8 N2 - BACKGROUND: There is much controversy about the ideal approach to the management of community acquired pneumonia (CAP). Recommendations differ from a pathogen directed approach to an empirical strategy with broad spectrum antibiotics. METHODS: In a prospective randomised open study performed between 1998 and 2000, a pathogen directed treatment (PDT) approach was compared with an empirical broad spectrum antibiotic treatment (EAT) strategy according to the ATS guidelines of 1993 in 262 hospitalised patients with CAP. Clinical efficacy was primarily determined by the length of hospital stay (LOS). Secondary outcome parameters for clinical efficacy were assessment of therapeutic failure on antibiotics, 30 day mortality, duration of antibiotic treatment, resolution of fever, side effects, and quality of life. RESULTS: Three hundred and three patients were enrolled in the study; 41 were excluded, leaving 262 with results available for analysis. No significant differences were found between the two treatment groups in LOS, 30 day mortality, clinical failure, or resolution of fever. Side effects, although they did not have a significant influence on the outcome parameters, occurred more frequently in patients in the EAT group than in those in the PDT group (60% v 17%, 95% CI -0.5 to -0.3; p<0.001). CONCLUSIONS: An EAT strategy with broad spectrum antibiotics for the management of hospitalised patients with CAP has comparable clinical efficacy to a PDT approach. SN - 0040-6376 UR - https://www.unboundmedicine.com/medline/citation/16061709/Comparison_between_pathogen_directed_antibiotic_treatment_and_empirical_broad_spectrum_antibiotic_treatment_in_patients_with_community_acquired_pneumonia:_a_prospective_randomised_study_ L2 - https://thorax.bmj.com/lookup/pmidlookup?view=long&amp;pmid=16061709 DB - PRIME DP - Unbound Medicine ER -