Abstract

MEDEROS SUST, Sandy et al. Hospital fatality for community-acquired pneumonia according to the initial antimicrobial treatment. Rev cubana med [online]. 2014, vol.53, n.2, pp.144-164. ISSN 0034-7523.

Objective: to determine lethality behavior of community acquired pneumonia as initial empirical antimicrobial therapy in hospitalized patients. Methods: a prospectively descriptive observational study was performed of case series, 421 patients with coincident diagnosis of community acquired pneumonia at admission and discharge from January 2012 to June 2013. Information from clinical records was used. Chi2 statistic and exact Fisher's test were used in the statistical analysis for differences in proportions; and the odds ratio to measure the strength of association antimicrobial-lethality products accepted confidence level was 95 % (p< 0.05). Results: the lowest lethality was observed in patients treated with cefuroxime (17 %), and highest in those treated with cefotaxime (44 %) and ceftriaxone (35 %), with statistically significant differences. The differences in mortality from pneumonia among those treated with cefuroxime and those treated with amoxicillin/sulbactam or ceftriaxone increased with patient age, which was also statistically significant. In patients with severe pneumonia and unlikely to recover, extremely high lethalities were found in those treated with ceftriaxone (81 %) and cefotaxime (75 %). Conclusions: cefuroxime was the antibiotic used initially associated with lower mortality, as opposed to the use of ceftriaxone or cefotaxime income. Amoxicillin/sulbactam, as initial empirical therapy, occupied an intermediate position.

Keywords : pneumonia; hospitalization; fatality.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )