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A Retrospective Study on Amoxicillin Susceptibility in Severe Haemophilus influenzae Pneumonia

Pierre Danneels1, Maria Concetta Postorino1,2, Alessio Strazzulla1,2

  • 1Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France.

The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien Des Maladies Infectieuses Et De La Microbiologie Medicale
|September 23, 2020
PubMed
Abstract

Insights

Amoxicillin resistance in Haemophilus influenzae (Hi) pneumonia remains stable, with no identified risk factors. Amoxicillin/clavulanic acid (AMC) resistance is very low, suggesting its potential use in treating Hi pneumonia.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pulmonology

Background:

  • * *Haemophilus influenzae* (Hi) pneumonia treatment is challenging due to widespread amoxicillin resistance.
  • * This study addresses the evolution of amoxicillin and amoxicillin/clavulanic acid (AMC) resistance in Hi and patient characteristics in severe pneumonia.

Purpose of the Study:

  • * To analyze trends in amoxicillin and AMC resistance in *Haemophilus influenzae* isolates.
  • * To characterize patients with severe *Haemophilus influenzae* pneumonia.
  • * To compare Hi pneumonia patients with *Streptococcus pneumoniae* pneumonia patients.

Main Methods:

  • * Retrospective observational study of severe pneumonia patients in ICU (2008-2017).
  • * Monitored susceptibility to amoxicillin and AMC over time.
  • * Compared clinical characteristics between Hi and *Streptococcus pneumoniae* pneumonia patients.
  • * Investigated risk factors for amoxicillin resistance in Hi.

Main Results:

  • * 113 Hi and 132 *Streptococcus pneumoniae* (Sp) pneumonia cases identified.
  • * Amoxicillin resistance in Hi remained stable at 20%; AMC resistance decreased to 0% by 2016-2017.
  • * Hi pneumonia patients had more comorbidities (COPD, bronchitis) and severe disease (HAP, VAP) than Sp patients.
  • * No risk factors for amoxicillin resistance in Hi were found.

Conclusions:

  • * Amoxicillin resistance in Hi is stable, with no identified risk factors.
  • * Extremely low AMC resistance suggests its utility for empiric treatment of Hi pneumonia.
  • * Hi pneumonia patients exhibit greater pulmonary comorbidity and disease severity compared to Sp pneumonia patients.

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