TY - JOUR
T1 - Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark
T2 - a retrospective cohort study
AU - Egelund, Gertrud Baunbæk
AU - Jensen, Andreas Vestergaard
AU - Andersen, Stine Bang
AU - Petersen, Pelle Trier
AU - Lindhardt, Bjarne Ørskov
AU - von Plessen, Christian
AU - Rohde, Gernot
AU - Ravn, Pernille
PY - 2017/4/20
Y1 - 2017/4/20
N2 - BACKGROUND: Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy.METHODS: Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment. We evaluated the association between mortality and treatment with empiric penicillin-G/V using logistic regression analysis.RESULTS: We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53).CONCLUSION: The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin-G/V was commonly used and not associated with increased mortality in patients with mild to moderate pneumonia. Our results are in agreement with current conservative antibiotic strategy as outlined in the Danish guidelines.
AB - BACKGROUND: Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy.METHODS: Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment. We evaluated the association between mortality and treatment with empiric penicillin-G/V using logistic regression analysis.RESULTS: We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53).CONCLUSION: The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin-G/V was commonly used and not associated with increased mortality in patients with mild to moderate pneumonia. Our results are in agreement with current conservative antibiotic strategy as outlined in the Danish guidelines.
KW - Age Distribution
KW - Aged
KW - Aged, 80 and over
KW - Anti-Bacterial Agents/therapeutic use
KW - Community-Acquired Infections/drug therapy
KW - Denmark/epidemiology
KW - Female
KW - Guideline Adherence
KW - Hospital Mortality
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Penicillins/therapeutic use
KW - Pneumonia, Bacterial/drug therapy
KW - Prognosis
KW - Retrospective Studies
KW - Time Factors
U2 - 10.1186/s12890-017-0404-8
DO - 10.1186/s12890-017-0404-8
M3 - Journal article
C2 - 28427381
SN - 1471-2466
VL - 17
JO - B M C Pulmonary Medicine
JF - B M C Pulmonary Medicine
M1 - 66
ER -