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Timing of antibiotic administration and outcomes of hospitalized patients with community-acquired and healthcare-associated pneumonia.
Clin Microbiol Infect. 2012 Nov; 18(11):1149-55.CM

Abstract

The effects of antibiotic timing on outcomes of patients with community-acquired pneumonia (CAP) are controversial. Moreover, no information is available regarding this issue in healthcare-associated pneumonia (HCAP). We aimed to determine the impact of antibiotic timing on 30-day mortality of patients with CAP and HCAP. Non-immunocompromised adults admitted to hospital through the emergency department (ED) with community-onset pneumonia were prospectively observed from 2001 to 2009. Patients who received prior antibiotics were excluded. Of 1593 patients with pneumonia who were analyzed, 1274 had CAP and 319 HCAP. The mean time from patient arrival at the ED until antibiotic administration was 5.8 h (standard deviation (SD) 3.5) in CAP and 6.1 h (SD 3.8) in HCAP (p 0.30). Mortality was higher in patients with HCAP (5.5% vs. 13.5%; p <0.001). After adjusting for confounding factors in a logistic regression analysis, the antibiotic administration ≤4 h was not associated with decreased 30-day mortality in patients with CAP (odds ratio (OR) 1.12, 95% confidence interval (CI) 0.57-2.21) and in patients with HCAP (OR 0.59, 95% CI 0.19-1.83). Similarly, antibiotic administration ≤8 h was not associated with decreased 30-day mortality in CAP (OR 1.58, 95% CI 0.64-3.88) and HCAP patients (OR 0.59, 95% CI 0.19-1.83). In conclusion, antibiotic administration within 4 or 8 h of arrival at the ED did not improve 30-day survival in hospitalized adults for CAP or HCAP.

Authors+Show Affiliations

Service of Infectious Diseases, Hospital Universitari de Bellvitge, Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22115052

Citation

Simonetti, A, et al. "Timing of Antibiotic Administration and Outcomes of Hospitalized Patients With Community-acquired and Healthcare-associated Pneumonia." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 18, no. 11, 2012, pp. 1149-55.
Simonetti A, Viasus D, Garcia-Vidal C, et al. Timing of antibiotic administration and outcomes of hospitalized patients with community-acquired and healthcare-associated pneumonia. Clin Microbiol Infect. 2012;18(11):1149-55.
Simonetti, A., Viasus, D., Garcia-Vidal, C., Adamuz, J., Roset, A., Manresa, F., Dorca, J., Gudiol, F., & Carratalà, J. (2012). Timing of antibiotic administration and outcomes of hospitalized patients with community-acquired and healthcare-associated pneumonia. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 18(11), 1149-55. https://doi.org/10.1111/j.1469-0691.2011.03709.x
Simonetti A, et al. Timing of Antibiotic Administration and Outcomes of Hospitalized Patients With Community-acquired and Healthcare-associated Pneumonia. Clin Microbiol Infect. 2012;18(11):1149-55. PubMed PMID: 22115052.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Timing of antibiotic administration and outcomes of hospitalized patients with community-acquired and healthcare-associated pneumonia. AU - Simonetti,A, AU - Viasus,D, AU - Garcia-Vidal,C, AU - Adamuz,J, AU - Roset,A, AU - Manresa,F, AU - Dorca,J, AU - Gudiol,F, AU - Carratalà,J, Y1 - 2011/11/24/ PY - 2011/11/26/entrez PY - 2011/11/26/pubmed PY - 2013/3/2/medline SP - 1149 EP - 55 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin Microbiol Infect VL - 18 IS - 11 N2 - The effects of antibiotic timing on outcomes of patients with community-acquired pneumonia (CAP) are controversial. Moreover, no information is available regarding this issue in healthcare-associated pneumonia (HCAP). We aimed to determine the impact of antibiotic timing on 30-day mortality of patients with CAP and HCAP. Non-immunocompromised adults admitted to hospital through the emergency department (ED) with community-onset pneumonia were prospectively observed from 2001 to 2009. Patients who received prior antibiotics were excluded. Of 1593 patients with pneumonia who were analyzed, 1274 had CAP and 319 HCAP. The mean time from patient arrival at the ED until antibiotic administration was 5.8 h (standard deviation (SD) 3.5) in CAP and 6.1 h (SD 3.8) in HCAP (p 0.30). Mortality was higher in patients with HCAP (5.5% vs. 13.5%; p <0.001). After adjusting for confounding factors in a logistic regression analysis, the antibiotic administration ≤4 h was not associated with decreased 30-day mortality in patients with CAP (odds ratio (OR) 1.12, 95% confidence interval (CI) 0.57-2.21) and in patients with HCAP (OR 0.59, 95% CI 0.19-1.83). Similarly, antibiotic administration ≤8 h was not associated with decreased 30-day mortality in CAP (OR 1.58, 95% CI 0.64-3.88) and HCAP patients (OR 0.59, 95% CI 0.19-1.83). In conclusion, antibiotic administration within 4 or 8 h of arrival at the ED did not improve 30-day survival in hospitalized adults for CAP or HCAP. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/22115052/Timing_of_antibiotic_administration_and_outcomes_of_hospitalized_patients_with_community_acquired_and_healthcare_associated_pneumonia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(14)60753-9 DB - PRIME DP - Unbound Medicine ER -