Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study

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 -