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Effectiveness of azithromycin in aspiration pneumonia: a prospective observational study.

Marumo S, Teranishi T, Higami Y, Koshimo Y, Kiyokawa H, Kato M - BMC Infect. Dis. (2014)

Bottom Line: The success rates of 1(st)-line antibiotic therapy, mortality, length of hospital stay, and total antibiotic costs were compared.Mortality and hospitalization periods did not differ between the 2 groups (11.1% vs. 8.3%, P = 0.753, and 22.3 ± 7.3 days vs. 20.5 ± 8.1 days, P = 0.654, respectively).The febrile period of the ABPC/SBT group was significantly shorter than that of the AZM group (P = 0.025).

View Article: PubMed Central - PubMed

Affiliation: Respiratory Disease Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan. marumo@kuhp.kyoto-u.ac.jp.

ABSTRACT

Background: Aspiration pneumonia is an urgent health concern with high mortality and long hospitalization in industrialized and aging countries. However, there is no information about the effectiveness of azithromycin (AZM) for the treatment of aspiration pneumonia. This study investigated if AZM is effective for the treatment of aspiration pneumonia.

Methods: Patients with aspiration pneumonia with no risk of multidrug-resistant pathogens were included in this prospective study at Kishiwada City Hospital from December 2011 to June 2013. Patients were divided into the ampicillin/sulbactam (ABPC/SBT) and AZM (intravenous injection) groups. The success rates of 1(st)-line antibiotic therapy, mortality, length of hospital stay, and total antibiotic costs were compared.

Results: There were 81 and 36 patients in the ABPC/SBT and AZM groups, respectively. There was no significant difference in the success rate of 1(st)-line antibiotics between the groups (74.1% vs. 75.0%, respectively, P = 1.000). Mortality and hospitalization periods did not differ between the 2 groups (11.1% vs. 8.3%, P = 0.753, and 22.3 ± 7.3 days vs. 20.5 ± 8.1 days, P = 0.654, respectively). However, the total antibiotic costs were significantly lower in the AZM group than the ABPC/SBT group (2.19 ± 1.65 × 10,000 yen vs. 2.94 ± 1.67 × 10,000 yen, respectively, P = 0.034). The febrile period of the ABPC/SBT group was significantly shorter than that of the AZM group (P = 0.025).

Conclusions: In this small prospective non-randomized observational study, we found no statistically significant differences in mortality or antibiotic failure in patients receiving AZM compared to ABPC/SBT for the treatment of patients with aspiration pneumonia who require hospital admission and have no risk of drug-resistant pathogens. Therefore, AZM may be another first choice of antibiotic treatment for patients with aspiration pneumonia when they have no risk of multidrug-resistant pathogens.

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Related in: MedlinePlus

Kaplan–Meier Curve of Febrile Periods. The febrile period of the ABPC/SBT group tended to be shorter than that of the AZM group. ABPC/SBT: ampicillin/sulbactam; AZM, azithromycin.
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Fig1: Kaplan–Meier Curve of Febrile Periods. The febrile period of the ABPC/SBT group tended to be shorter than that of the AZM group. ABPC/SBT: ampicillin/sulbactam; AZM, azithromycin.

Mentions: During the study period, 498 patients were admitted to our hospital. The Kaplan–Meier plot of febrility is shown in Figure 1. Briefly, 192 patients were diagnosed as NHCAP group B, including 148 patients with aspiration pneumonia. Then, 31 patients were excluded because they were treated with other antibiotics. Finally, 81 and 36 patients were included in the ABPC/SBT and AZM groups, respectively. The baseline characteristics of the subjects are shown in Table 1. There were no significant differences between the AZM and ABPC/SBT groups with respect to sex, age, severity, and diagnostic category of aspiration pneumonia.Figure 1


Effectiveness of azithromycin in aspiration pneumonia: a prospective observational study.

Marumo S, Teranishi T, Higami Y, Koshimo Y, Kiyokawa H, Kato M - BMC Infect. Dis. (2014)

Kaplan–Meier Curve of Febrile Periods. The febrile period of the ABPC/SBT group tended to be shorter than that of the AZM group. ABPC/SBT: ampicillin/sulbactam; AZM, azithromycin.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4265472&req=5

Fig1: Kaplan–Meier Curve of Febrile Periods. The febrile period of the ABPC/SBT group tended to be shorter than that of the AZM group. ABPC/SBT: ampicillin/sulbactam; AZM, azithromycin.
Mentions: During the study period, 498 patients were admitted to our hospital. The Kaplan–Meier plot of febrility is shown in Figure 1. Briefly, 192 patients were diagnosed as NHCAP group B, including 148 patients with aspiration pneumonia. Then, 31 patients were excluded because they were treated with other antibiotics. Finally, 81 and 36 patients were included in the ABPC/SBT and AZM groups, respectively. The baseline characteristics of the subjects are shown in Table 1. There were no significant differences between the AZM and ABPC/SBT groups with respect to sex, age, severity, and diagnostic category of aspiration pneumonia.Figure 1

Bottom Line: The success rates of 1(st)-line antibiotic therapy, mortality, length of hospital stay, and total antibiotic costs were compared.Mortality and hospitalization periods did not differ between the 2 groups (11.1% vs. 8.3%, P = 0.753, and 22.3 ± 7.3 days vs. 20.5 ± 8.1 days, P = 0.654, respectively).The febrile period of the ABPC/SBT group was significantly shorter than that of the AZM group (P = 0.025).

View Article: PubMed Central - PubMed

Affiliation: Respiratory Disease Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan. marumo@kuhp.kyoto-u.ac.jp.

ABSTRACT

Background: Aspiration pneumonia is an urgent health concern with high mortality and long hospitalization in industrialized and aging countries. However, there is no information about the effectiveness of azithromycin (AZM) for the treatment of aspiration pneumonia. This study investigated if AZM is effective for the treatment of aspiration pneumonia.

Methods: Patients with aspiration pneumonia with no risk of multidrug-resistant pathogens were included in this prospective study at Kishiwada City Hospital from December 2011 to June 2013. Patients were divided into the ampicillin/sulbactam (ABPC/SBT) and AZM (intravenous injection) groups. The success rates of 1(st)-line antibiotic therapy, mortality, length of hospital stay, and total antibiotic costs were compared.

Results: There were 81 and 36 patients in the ABPC/SBT and AZM groups, respectively. There was no significant difference in the success rate of 1(st)-line antibiotics between the groups (74.1% vs. 75.0%, respectively, P = 1.000). Mortality and hospitalization periods did not differ between the 2 groups (11.1% vs. 8.3%, P = 0.753, and 22.3 ± 7.3 days vs. 20.5 ± 8.1 days, P = 0.654, respectively). However, the total antibiotic costs were significantly lower in the AZM group than the ABPC/SBT group (2.19 ± 1.65 × 10,000 yen vs. 2.94 ± 1.67 × 10,000 yen, respectively, P = 0.034). The febrile period of the ABPC/SBT group was significantly shorter than that of the AZM group (P = 0.025).

Conclusions: In this small prospective non-randomized observational study, we found no statistically significant differences in mortality or antibiotic failure in patients receiving AZM compared to ABPC/SBT for the treatment of patients with aspiration pneumonia who require hospital admission and have no risk of drug-resistant pathogens. Therefore, AZM may be another first choice of antibiotic treatment for patients with aspiration pneumonia when they have no risk of multidrug-resistant pathogens.

Show MeSH
Related in: MedlinePlus