Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study

Gertrud Baunbæk Egelund, Andreas Vestergaard Jensen, Stine Bang Andersen, Pelle Trier Petersen, Bjarne Ørskov Lindhardt, Christian von Plessen, Gernot Rohde, Pernille Ravn

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Abstract

BACKGROUND: Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy.

METHODS: Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment. We evaluated the association between mortality and treatment with empiric penicillin-G/V using logistic regression analysis.

RESULTS: We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53).

CONCLUSION: The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin-G/V was commonly used and not associated with increased mortality in patients with mild to moderate pneumonia. Our results are in agreement with current conservative antibiotic strategy as outlined in the Danish guidelines.

Original languageEnglish
Article number66
JournalB M C Pulmonary Medicine
Volume17
Number of pages9
ISSN1471-2466
DOIs
Publication statusPublished - 20 Apr 2017

Keywords

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents/therapeutic use
  • Community-Acquired Infections/drug therapy
  • Denmark/epidemiology
  • Female
  • Guideline Adherence
  • Hospital Mortality
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Penicillins/therapeutic use
  • Pneumonia, Bacterial/drug therapy
  • Prognosis
  • Retrospective Studies
  • Time Factors

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