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Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia

Forest W Arnold1, Gustavo Lopardo2, Timothy L Wiemken1

  • 1Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, United States.

Respiratory Medicine
|June 30, 2018
PubMed
Abstract

Insights

Macrolide antibiotics significantly reduced in-hospital mortality for patients with community-acquired pneumonia (CAP) and bacteremia. This finding supports macrolide use in hospitalized CAP patients with bloodstream infections.

Area of Science:

  • Infectious Diseases
  • Clinical Medicine
  • Pharmacology

Background:

  • Community-acquired pneumonia (CAP) can lead to bacteremia.
  • Understanding the impact of macrolide treatment on CAP with bacteremia is crucial for clinical practice.

Purpose of the Study:

  • To compare clinical outcomes in patients with CAP and bacteremia treated with or without macrolides.
  • To evaluate the efficacy of macrolides in reducing mortality and improving other outcomes in this patient population.

Main Methods:

  • Secondary analysis of the Community-Acquired Pneumonia Organization database.
  • Patients with CAP and positive blood cultures were grouped based on macrolide use in initial antimicrobial therapy.
  • Outcomes assessed included in-hospital mortality, 30-day mortality, length of stay, and time to clinical stability.

Main Results:

  • Of 549 patients with CAP and bacteremia, 45% received macrolides.
  • In-hospital mortality was significantly lower in the macrolide group (7.3% vs. 18.9%, adjusted RR 0.54).
  • 30-day mortality, length of stay, and time to clinical stability did not differ significantly between groups.

Conclusions:

  • Macrolide treatment was associated with significantly reduced in-hospital mortality in patients with CAP and bacteremia.
  • The findings support the use of macrolides for hospitalized patients diagnosed with CAP and bacteremia.
  • Further research may explore specific macrolide benefits in subgroups.
Keywords:
Antimicrobial treatmentBacteremiaCommunity-acquired pneumoniaMortality

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