Multivariate analyses of the association between antibiotic therapy and clinical outcomes
| Outcome measures | Total (n=5240) | β-lactam therapy (n=2001) | β-lactam/ macrolide combination therapy (n=3239) | Adjusted OR (95% CI) | p Value |
|---|---|---|---|---|---|
| 30 day IP death rate | 1281 (24.4) | 536 (26.8) | 745 (23.0) | 0.72 (0.60 to 0.85)* | <0.001 |
| ICU admission | 419 (8) | 136 (6.8) | 282 (8.7) | 0.94 (0.72 to 1.22)† | 0.635 |
| Need for MV | 151 (2.9) | 58 (2.9) | 93 (2.9) | 0.99 (0.71 to 1.38)† | 0.508 |
| Need for INS | 130 (2.5) | 42 (2.1) | 88 (2.7) | 0.87 (0.55 to 1.38)† | 0.544 |
| 30-day IP death rate stratified by pneumonia severity | |||||
| Low severity (CURB65=0–1) | 201/2247 (8.9) | 95/908 (10.5) | 106/1339 (7.9) | 0.80 (0.56 to 1.16)‡ | 0.238 |
| Moderate severity (CURB65=2) | 370/1480 (25) | 171/561 (30.5) | 199/919 (21.7) | 0.54 (0.41 to 0.72)‡ | <0.001 |
| High severity (CURB65≥3) | 710/1513 (46.9) | 270/532 (50.8) | 440/981 (44.9) | 0.76 (0.60 to 0.96)‡ | 0.025 |
Values given as n (%).
*OR adjusted for age, sex, binary variables within CURB65 excluding age (confusion, urea>7 mmol/l, respiratory rate ≥30/min, systolic blood pressure<90 mmHg or diastolic blood pressure ≤60 mmHg), individual comorbidities, intravenous antibiotic use, nursing home residency and ICU admission.
†OR adjusted for age, sex, binary variables within CURB65 excluding age (confusion, urea>7 mmol/l, respiratory rate ≥30/min, systolic blood pressure<90 mmHg or diastolic blood pressure ≤60 mmHg), individual comorbidities, intravenous antibiotic use and nursing home residency.
‡OR adjusted for sex, individual comorbidities, intravenous antibiotic use, nursing home residency and ICU admission.
ICU, intensive care unit; IP, inpatient; MV, mechanical ventilation; INS, inotropic support.