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Risk factors for complicated community-acquired pneumonia course in patients treated with β-lactam monotherapy
Giedrė Cincilevičiūtė1,2, Vaida Averjanovaitė3, Rūta Mereškevičienė3
1Clinic of Chest Diseases, Immunology and Allergology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. giedre.cin@gmail.com.
Introduction:
We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with b-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course.
Material And Methods:
A prospective observational study was conducted at the Pulmonology and Allergology Department in a tertiary care university hospital. 253 consecutive patients diagnosed with CAP requiring hospitalisation were enrolled. Hospital admission was based on PSI or CRB-65 scores, severe comorbidities, signs of intoxication, aspiration risk, social risk consider-ations, ineffective prior antibiotic treatment.
Results:
Fourty seven percent of the subjects had complications on admission, 13% developed new CAP complications during inpatient treatment. Overall, 53% of individuals had a complicated CAP course. 30-day mortality rate was 5.9%. The factors predicting a complicated CAP course were as follows: neuromuscular disease, multilobar opacities on chest X-ray (or computed tomography), and clinically unstable condition as evaluated using Halm's criteria.
Conclusions:
The mortality rate in CAP patients treated with b-lactam monotherapy is low. Neuromuscular disease, multilobar opacities, and clinically unstable condition as evaluated using Halm's criteria predict a complicated CAP course.
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