Are third-generation cephalosporins associated with a better prognosis than amoxicillin–clavulanate in patients hospitalized in the medical ward for community-onset pneumonia?
We aimed to assess whether treatment with ceftriaxone/cefotaxime is associated with lower in-hospital mortality than amoxicillin–clavulanate in pati0ents hospitalized in medical wards for community-onset pneumonia. We conducted a retrospective and multicentre study of patients hospitalized in French...
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| Veröffentlicht in: | Clinical microbiology and infection 2018-11, Vol.24 (11), p.1171-1176 |
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| creator | Batard, E. Javaudin, F. Kervagoret, E. Caruana, E. Le Bastard, Q. Chapelet, G. Goffinet, N. Montassier, E. |
| description | We aimed to assess whether treatment with ceftriaxone/cefotaxime is associated with lower in-hospital mortality than amoxicillin–clavulanate in pati0ents hospitalized in medical wards for community-onset pneumonia.
We conducted a retrospective and multicentre study of patients hospitalized in French medical wards for community-onset pneumonia between 2002 and 2015. Treatments with ceftriaxone/cefotaxime or amoxicillin–clavulanate were defined by their start in the emergency department for a duration of 5 days or more with no other β-lactam. A logistic regression analysis was performed on the overall population, and a propensity score analysis was restricted to patients treated with either ceftriaxone/cefotaxime or amoxicillin–clavulanate.
1698 patients (median age, 80 y) were included, of which 716 and 198 were treated with amoxicillin–clavulanate and ceftriaxone/cefotaxime, respectively. In-hospital mortality was 10% (9–12%). In multivariate analysis, factors associated with in-hospital mortality were treatment with ceftriaxone/cefotaxime (aOR 2.9; (1.4–5.7)), pneumonia severity index class 4 or 5 (aOR 7.8 (4.3–15.7)), do-not-resuscitate order (aOR 8.7 (5.2–14.6)) and fluid therapy (aOR 6.3 (2.5–15.1)). The propensity score analysis was performed on 178 patients treated with ceftriaxone/cefotaxime matched with 178 patients treated with amoxicillin–clavulanate; no significant association between treatment with ceftriaxone/cefotaxime and in-hospital mortality was found (OR 1.5 (0.7–3.0)).
In the largest study aiming to compare amoxicillin–clavulanate and ceftriaxone/cefotaxime in community-onset pneumonia, ceftriaxone/cefotaxime was not associated with lower in-hospital mortality than amoxicillin–clavulanate. Our results suggest that ceftriaxone/cefotaxime should not be preferred over amoxicillin–clavulanate for patients hospitalized in medical wards with community-onset pneumonia. |
| doi_str_mv | 10.1016/j.cmi.2018.06.021 |
| format | Article |
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We conducted a retrospective and multicentre study of patients hospitalized in French medical wards for community-onset pneumonia between 2002 and 2015. Treatments with ceftriaxone/cefotaxime or amoxicillin–clavulanate were defined by their start in the emergency department for a duration of 5 days or more with no other β-lactam. A logistic regression analysis was performed on the overall population, and a propensity score analysis was restricted to patients treated with either ceftriaxone/cefotaxime or amoxicillin–clavulanate.
1698 patients (median age, 80 y) were included, of which 716 and 198 were treated with amoxicillin–clavulanate and ceftriaxone/cefotaxime, respectively. In-hospital mortality was 10% (9–12%). In multivariate analysis, factors associated with in-hospital mortality were treatment with ceftriaxone/cefotaxime (aOR 2.9; (1.4–5.7)), pneumonia severity index class 4 or 5 (aOR 7.8 (4.3–15.7)), do-not-resuscitate order (aOR 8.7 (5.2–14.6)) and fluid therapy (aOR 6.3 (2.5–15.1)). The propensity score analysis was performed on 178 patients treated with ceftriaxone/cefotaxime matched with 178 patients treated with amoxicillin–clavulanate; no significant association between treatment with ceftriaxone/cefotaxime and in-hospital mortality was found (OR 1.5 (0.7–3.0)).
In the largest study aiming to compare amoxicillin–clavulanate and ceftriaxone/cefotaxime in community-onset pneumonia, ceftriaxone/cefotaxime was not associated with lower in-hospital mortality than amoxicillin–clavulanate. Our results suggest that ceftriaxone/cefotaxime should not be preferred over amoxicillin–clavulanate for patients hospitalized in medical wards with community-onset pneumonia.</description><identifier>ISSN: 1198-743X</identifier><identifier>EISSN: 1469-0691</identifier><identifier>DOI: 10.1016/j.cmi.2018.06.021</identifier><identifier>PMID: 29964229</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aged ; Aged, 80 and over ; Amoxicillin-Potassium Clavulanate Combination - therapeutic use ; Amoxicillin–clavulanate ; Anti-Bacterial Agents - therapeutic use ; Cefotaxime ; Ceftriaxone ; Cephalosporins - classification ; Cephalosporins - therapeutic use ; Community-Acquired Infections - drug therapy ; Community-onset pneumonia ; Female ; Humans ; Male ; Mortality ; Pneumonia, Bacterial - drug therapy ; Retrospective Studies</subject><ispartof>Clinical microbiology and infection, 2018-11, Vol.24 (11), p.1171-1176</ispartof><rights>2018 European Society of Clinical Microbiology and Infectious Diseases</rights><rights>Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3111-dd0dc6f649ee80383d090a9bd0e45c65485f7c73d3bc7084eb193204052fde633</citedby><cites>FETCH-LOGICAL-c3111-dd0dc6f649ee80383d090a9bd0e45c65485f7c73d3bc7084eb193204052fde633</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29964229$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Batard, E.</creatorcontrib><creatorcontrib>Javaudin, F.</creatorcontrib><creatorcontrib>Kervagoret, E.</creatorcontrib><creatorcontrib>Caruana, E.</creatorcontrib><creatorcontrib>Le Bastard, Q.</creatorcontrib><creatorcontrib>Chapelet, G.</creatorcontrib><creatorcontrib>Goffinet, N.</creatorcontrib><creatorcontrib>Montassier, E.</creatorcontrib><title>Are third-generation cephalosporins associated with a better prognosis than amoxicillin–clavulanate in patients hospitalized in the medical ward for community-onset pneumonia?</title><title>Clinical microbiology and infection</title><addtitle>Clin Microbiol Infect</addtitle><description>We aimed to assess whether treatment with ceftriaxone/cefotaxime is associated with lower in-hospital mortality than amoxicillin–clavulanate in pati0ents hospitalized in medical wards for community-onset pneumonia.
We conducted a retrospective and multicentre study of patients hospitalized in French medical wards for community-onset pneumonia between 2002 and 2015. Treatments with ceftriaxone/cefotaxime or amoxicillin–clavulanate were defined by their start in the emergency department for a duration of 5 days or more with no other β-lactam. A logistic regression analysis was performed on the overall population, and a propensity score analysis was restricted to patients treated with either ceftriaxone/cefotaxime or amoxicillin–clavulanate.
1698 patients (median age, 80 y) were included, of which 716 and 198 were treated with amoxicillin–clavulanate and ceftriaxone/cefotaxime, respectively. In-hospital mortality was 10% (9–12%). In multivariate analysis, factors associated with in-hospital mortality were treatment with ceftriaxone/cefotaxime (aOR 2.9; (1.4–5.7)), pneumonia severity index class 4 or 5 (aOR 7.8 (4.3–15.7)), do-not-resuscitate order (aOR 8.7 (5.2–14.6)) and fluid therapy (aOR 6.3 (2.5–15.1)). The propensity score analysis was performed on 178 patients treated with ceftriaxone/cefotaxime matched with 178 patients treated with amoxicillin–clavulanate; no significant association between treatment with ceftriaxone/cefotaxime and in-hospital mortality was found (OR 1.5 (0.7–3.0)).
In the largest study aiming to compare amoxicillin–clavulanate and ceftriaxone/cefotaxime in community-onset pneumonia, ceftriaxone/cefotaxime was not associated with lower in-hospital mortality than amoxicillin–clavulanate. Our results suggest that ceftriaxone/cefotaxime should not be preferred over amoxicillin–clavulanate for patients hospitalized in medical wards with community-onset pneumonia.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amoxicillin-Potassium Clavulanate Combination - therapeutic use</subject><subject>Amoxicillin–clavulanate</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Cefotaxime</subject><subject>Ceftriaxone</subject><subject>Cephalosporins - classification</subject><subject>Cephalosporins - therapeutic use</subject><subject>Community-Acquired Infections - drug therapy</subject><subject>Community-onset pneumonia</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mortality</subject><subject>Pneumonia, Bacterial - drug therapy</subject><subject>Retrospective Studies</subject><issn>1198-743X</issn><issn>1469-0691</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2O1DAQhSMEYoaBA7BBXrJJKNuJOxYLNBrxJ43EBiR2lmNXJm4ldrCd-WHFHTgJV-IkuNUDS1ZVUr33Sa9eVT2n0FCg4tW-MYtrGNC-AdEAow-qU9oKWYOQ9GHZqezrXcu_nlRPUtoDAOO8fVydMClFy5g8rX6dRyR5ctHWV-gx6uyCJwbXSc8hrSE6n4hOKRinM1py4_JENBkwZ4xkjeHKh-RSQWhP9BJunXHz7PzvHz_NrK-3WfviI86TtaDR50SmwnVZz-574ZVDnpAsaJ3RM7nR0ZIxRGLCsmze5bs6-ISZrB63JXin3zytHo16Tvjsfp5VX969_Xzxob789P7jxfllbTiltLYWrBGjaCViD7znFiRoOVjAtjOia_tu3Jkdt3wwO-hbHKjkDFro2GhRcH5WvTxyS8hvG6asFpcMziURhi0pBoLvaEfZQUqPUhNDShFHtUa36HinKKhDU2qvSlPq0JQCoUpTxfPiHr8NJf0_x99qiuD1UYAl5LXDqJIpDzTlUxFNVja4_-D_AGL1qi8</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Batard, E.</creator><creator>Javaudin, F.</creator><creator>Kervagoret, E.</creator><creator>Caruana, E.</creator><creator>Le Bastard, Q.</creator><creator>Chapelet, G.</creator><creator>Goffinet, N.</creator><creator>Montassier, E.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201811</creationdate><title>Are third-generation cephalosporins associated with a better prognosis than amoxicillin–clavulanate in patients hospitalized in the medical ward for community-onset pneumonia?</title><author>Batard, E. ; Javaudin, F. ; Kervagoret, E. ; Caruana, E. ; Le Bastard, Q. ; Chapelet, G. ; Goffinet, N. ; Montassier, E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3111-dd0dc6f649ee80383d090a9bd0e45c65485f7c73d3bc7084eb193204052fde633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amoxicillin-Potassium Clavulanate Combination - therapeutic use</topic><topic>Amoxicillin–clavulanate</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Cefotaxime</topic><topic>Ceftriaxone</topic><topic>Cephalosporins - classification</topic><topic>Cephalosporins - therapeutic use</topic><topic>Community-Acquired Infections - drug therapy</topic><topic>Community-onset pneumonia</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mortality</topic><topic>Pneumonia, Bacterial - drug therapy</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Batard, E.</creatorcontrib><creatorcontrib>Javaudin, F.</creatorcontrib><creatorcontrib>Kervagoret, E.</creatorcontrib><creatorcontrib>Caruana, E.</creatorcontrib><creatorcontrib>Le Bastard, Q.</creatorcontrib><creatorcontrib>Chapelet, G.</creatorcontrib><creatorcontrib>Goffinet, N.</creatorcontrib><creatorcontrib>Montassier, E.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical microbiology and infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Batard, E.</au><au>Javaudin, F.</au><au>Kervagoret, E.</au><au>Caruana, E.</au><au>Le Bastard, Q.</au><au>Chapelet, G.</au><au>Goffinet, N.</au><au>Montassier, E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are third-generation cephalosporins associated with a better prognosis than amoxicillin–clavulanate in patients hospitalized in the medical ward for community-onset pneumonia?</atitle><jtitle>Clinical microbiology and infection</jtitle><addtitle>Clin Microbiol Infect</addtitle><date>2018-11</date><risdate>2018</risdate><volume>24</volume><issue>11</issue><spage>1171</spage><epage>1176</epage><pages>1171-1176</pages><issn>1198-743X</issn><eissn>1469-0691</eissn><abstract>We aimed to assess whether treatment with ceftriaxone/cefotaxime is associated with lower in-hospital mortality than amoxicillin–clavulanate in pati0ents hospitalized in medical wards for community-onset pneumonia.
We conducted a retrospective and multicentre study of patients hospitalized in French medical wards for community-onset pneumonia between 2002 and 2015. Treatments with ceftriaxone/cefotaxime or amoxicillin–clavulanate were defined by their start in the emergency department for a duration of 5 days or more with no other β-lactam. A logistic regression analysis was performed on the overall population, and a propensity score analysis was restricted to patients treated with either ceftriaxone/cefotaxime or amoxicillin–clavulanate.
1698 patients (median age, 80 y) were included, of which 716 and 198 were treated with amoxicillin–clavulanate and ceftriaxone/cefotaxime, respectively. In-hospital mortality was 10% (9–12%). In multivariate analysis, factors associated with in-hospital mortality were treatment with ceftriaxone/cefotaxime (aOR 2.9; (1.4–5.7)), pneumonia severity index class 4 or 5 (aOR 7.8 (4.3–15.7)), do-not-resuscitate order (aOR 8.7 (5.2–14.6)) and fluid therapy (aOR 6.3 (2.5–15.1)). The propensity score analysis was performed on 178 patients treated with ceftriaxone/cefotaxime matched with 178 patients treated with amoxicillin–clavulanate; no significant association between treatment with ceftriaxone/cefotaxime and in-hospital mortality was found (OR 1.5 (0.7–3.0)).
In the largest study aiming to compare amoxicillin–clavulanate and ceftriaxone/cefotaxime in community-onset pneumonia, ceftriaxone/cefotaxime was not associated with lower in-hospital mortality than amoxicillin–clavulanate. Our results suggest that ceftriaxone/cefotaxime should not be preferred over amoxicillin–clavulanate for patients hospitalized in medical wards with community-onset pneumonia.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>29964229</pmid><doi>10.1016/j.cmi.2018.06.021</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical microbiology and infection, 2018-11, Vol.24 (11), p.1171-1176 |
| issn | 1198-743X 1469-0691 |
| language | eng |
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| subjects | Aged Aged, 80 and over Amoxicillin-Potassium Clavulanate Combination - therapeutic use Amoxicillin–clavulanate Anti-Bacterial Agents - therapeutic use Cefotaxime Ceftriaxone Cephalosporins - classification Cephalosporins - therapeutic use Community-Acquired Infections - drug therapy Community-onset pneumonia Female Humans Male Mortality Pneumonia, Bacterial - drug therapy Retrospective Studies |
| title | Are third-generation cephalosporins associated with a better prognosis than amoxicillin–clavulanate in patients hospitalized in the medical ward for community-onset pneumonia? |
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