A Subgroup of Patients With Hospital-acquired Pneumonia Do Not Require Broad-spectrum Gram-negative Antimicrobial Coverage

Author:

Russell Clark D123ORCID,Whittaker Ed1,Dee Dominic P1,Farquhar Eilidh1,Saenz de Villaverde Alba1,Evans Morgan H2,Laurenson Ian F3,Mackintosh Claire L2,Cevik Muge234

Affiliation:

1. University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, Edinburgh BioQuarter, Edinburgh, United Kingdom

2. National Health Service Lothian Infection Service, Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, United Kingdom

3. National Health Service Lothian Infection Service, Clinical Microbiology, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom

4. Infection and Global Health Research, School of Medicine, University of St Andrews, Fife, United Kingdom

Abstract

Abstract Among 200 patients developing hospital-acquired pneumonia (HAP) outside the intensive care unit, 61% were treated empirically without broad-spectrum Gram-negative coverage, with clinical cure in 69.7%. Lower disease severity markers (systemic inflammatory response syndrome, hypoxia, tachypnoea, neutrophilia) and the absence of diabetes mellitus and prior doxycycline treatment (but not the time to HAP onset) identified patients not requiring broad-spectrum Gram-negative coverage.

Funder

Edinburgh Clinical Academic Track

Wellcome Trust

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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