ArticleJournal of general internal medicine2012
Guideline-based antibiotics and mortality in healthcare-associated pneumonia.
Article in Journal of general internal medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Comparative clinical outcomes of ampicillin/sulbactam versus antipseudomonal broad-spectrum antibiotics for community-onset aspiration pneumonia: a propensity score-matched retrospective cohort study based on guideline-recommended strategies in a secondary care hospital in Japan.Journal of rural medicine : JRM · 2026Article
- Health care-associated pneumonia in the intensive care unit: Guideline-concordant antibiotics and outcomes.Journal of critical care · 2016Article
- Management of ventilator-associated pneumonia in intensive care units: a mixed methods study assessing barriers and facilitators to guideline adherence.BMC infectious diseases · 2016Article
- Antimicrobial de-escalation of treatment for healthcare-associated pneumonia within the Veterans Healthcare Administration.The Journal of antimicrobial chemotherapy · 2016Article
- Trends in Antibiotic Use and Nosocomial Pathogens in Hospitalized Veterans With Pneumonia at 128 Medical Centers, 2006-2010.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Article
- Application of a methicillin-resistant Staphylococcus aureus risk score for community-onset pneumonia patients and outcomes with initial treatment.BMC infectious diseases · 2015Article
- Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management.Clinical microbiology reviews · 2015Review
- Association of guideline-based antimicrobial therapy and outcomes in healthcare-associated pneumonia.The Journal of antimicrobial chemotherapy · 2015Article
- Healthcare-associated Pneumonia and Aspiration Pneumonia.Aging and disease · 2015Review
- Audit and Feedback-Focused approach to Evidence-based Care in Treating patients with pneumonia in hospital (AFFECT Study).The Canadian journal of hospital pharmacy · 2014Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundGuidelines recommend administration of antibiotics with activity against methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa for treatment of healthcare-associated pneumonia (HCAP). It is unclear if this therapy improves outcomes for patients with HCAP.
objectiveTo determine if administration of guideline-similar therapy (GST) was associated with a reduction in 30-day mortality for HCAP.
designMulti-center retrospective study.
participantsThirteen hundred and eleven admissions for HCAP in six Veterans Affairs Medical Centers.
interventionsEach admission was classified as receiving GST, anti-MRSA or anti-pseudomonal components of GST, or other non-HCAP therapy initiated within 48 hours of hospitalization. Association between 30-day mortality and GST was estimated with a logistic regression model that included GST, propensity to receive GST, probability of recovering an organism from culture resistant to antibiotics traditionally used to treat community-acquired pneumonia (CAP-resistance), and a GST by CAP-resistance probability interaction. MAIN MEASURES: Odds ratios and 95% confidence intervals [OR (95% CI)] of 30-day mortality for patients treated with GST and predicted probability of recovering a CAP-resistant organism, and ratio of odds ratios [ROR (95% CI)] for treatment by CAP-resistance probability interaction. KEY
resultsReceipt of GST was associated with increased odds of 30-day mortality [OR = 2.11 (1.11, 4.04), P = 0.02)] as was the predicted probability of recovering a CAP-resistant organism [OR = 1.67 (1.26, 2.20), P < 0.001 for a 25% increase in probability]. An interaction between predicted probability of recovering a CAP-resistant organism and receipt of GST demonstrated lower mortality with GST at high probability of CAP resistance [ROR = 0.71(≤1.00) for a 25% increase in probability, P = 0.05].
conclusionsFor HCAP patients with high probability of CAP-resistant organisms, GST was associated with lower mortality. Consideration of the magnitude of patient-specific risk for CAP-resistant organisms should be considered when selecting HCAP therapy.
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