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Amoxicillin/clavulanate activity against bacteria isolated in severe community-acquired pneumonia: a retrospective

A Sarr1, M A Matta1, F Kayembe1

  • 1Department of Infectious and Tropical Diseases, Groupe Hospitalier Sud Ile de France, Melun, France.

Infectious Diseases Now
|July 27, 2025
PubMed
Abstract

Insights

Amoxicillin-clavulanate (AMC) is a suitable antibiotic for severe community-acquired pneumonia (sCAP) in patients without recent antibiotic exposure. AMC offers ecological benefits over third-generation cephalosporins (3GCs).

Area of Science:

  • Infectious Diseases
  • Antimicrobial Stewardship
  • Clinical Microbiology

Background:

  • Severe community-acquired pneumonia (sCAP) necessitates prompt empirical antibiotic treatment.
  • Amoxicillin-clavulanate (AMC), a WHO AWaRe
  • Access
  • antibiotic, is a potential alternative to third-generation cephalosporins (3GCs) due to ecological advantages.

Purpose of the Study:

  • To evaluate amoxicillin-clavulanate (AMC) susceptibility in bacterial isolates from sCAP patients.
  • To identify factors linked to AMC resistance in sCAP.

Main Methods:

  • Retrospective, single-center study conducted in an ICU from 2019 to 2021.
  • Inclusion of sCAP patients with positive respiratory cultures within 48 hours.

Main Results:

  • Analysis of 212 isolates from 185 sCAP patients.
  • Overall AMC susceptibility was 83.5%, with high rates for S. pneumoniae (97.9%), S. aureus (96.1%), and H. influenzae (84.6%).
  • Prior antibiotic use within three months was the sole independent predictor of AMC resistance (p < 0.00001); susceptibility was 90.9% in patients without recent antibiotic exposure.

Conclusions:

  • Amoxicillin-clavulanate (AMC) is a viable empirical treatment for sCAP in patients without recent antibiotic exposure.
  • AMC provides greater ecological benefits compared to third-generation cephalosporins (3GCs).
Keywords:
AWaReAmoxicillin/clavulanateCephalosporinSevere community acquired pneumonia

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