Adverse hospital outcomes associated with the choice of empiric antibiotics in Klebsiella pneumoniae pneumonia: a retrospective observational study
Annals of the Academy of Medicine, Singapore
; : 642-646, 2007.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-250790
Biblioteca responsável:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>In Malaysia, Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalisation.</p><p><b>PATIENTS AND METHODS</b>With concern over its rising microbial resistance, we explored the association of empiric antibiotics choices with the hospital outcomes of patients treated for microbial proven K. pneumoniae pneumonia in an urban-based teaching hospital.</p><p><b>RESULTS</b>In 313 eligible cases reviewed retrospectively, hospital mortality and requirement for ventilation were 14.3% and 10.8% respectively. Empiric regimes that had in vitro resistance to at least one empiric antibiotic (n = 90) were associated with higher hospital mortality (23.3% vs. 10.8%, P = 0.004) with risk increased by about two-fold [Odds ratio (OR), 2.5; 95% confidence interval (CI), 1.3 to 4.8]. Regimes (n = 84) other than the commonly recommended "standard" regimes (a beta-lactam stable antibiotic with or without a acrolide) were associated with higher ventilation rates (16.7% vs. 8.8%, P = 0.047) with similar increased risk [OR, 2.0; 95% CI, 1.0 to 4.3].</p><p><b>CONCLUSIONS</b>Our findings reiterate the clinical relevance of in vitro microbial resistance in adult K. pneumoniae pneumonia and support empiric regimes that contain beta-lactam stable antibiotics.</p>
Texto completo:
Disponível
Contexto em Saúde:
Doenças Negligenciadas
/
ODS3 - Meta 3.3 Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
Problema de saúde:
Doenças Negligenciadas
/
Zoonoses
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Resistência Antimicrobiana
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Pneumonía
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Farmacologia
/
Respiração Artificial
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Técnicas In Vitro
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Infecções por Klebsiella
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Epidemiologia
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Estudos Retrospectivos
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Avaliação de Resultados em Cuidados de Saúde
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Mortalidade Hospitalar
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Infecções Comunitárias Adquiridas
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Farmacorresistência Bacteriana
Tipo de estudo:
Estudo observacional
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Annals of the Academy of Medicine, Singapore
Ano de publicação:
2007
Tipo de documento:
Artigo