ArticleCritical care (London, England)2013
Initial use of one or two antibiotics for critically ill patients with community-acquired pneumonia: impact on survival and bacterial resistance.
Article in Critical care (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Is β-Lactam Plus Macrolide More Effective than β-Lactam Plus Fluoroquinolone among Patients with Severe Community-Acquired Pneumonia?: a Systemic Review and Meta-Analysis.Journal of Korean medical science · 2017Pooled it
- Impact of macrolide therapy on clinical outcomes in hospitalized pneumonia patients: a retrospective study from Lebanese hospitals.Scientific reports · 2025Article
- Macrolide Therapy in Patients with Sepsis or Septic Shock: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Comparison of initial empirical antibiotic regimens in severe community-acquired pneumonia: a network meta-analysis.BMC pulmonary medicine · 2025Article
- Addition of Macrolide Antibiotics for Hospital Treatment of Community-Acquired Pneumonia.The Journal of infectious diseases · 2025Article
- Diagnostic Performance and Impact on Antimicrobial Treatment of a Multiplex Polymerase Chain Reaction in Critically Ill Patients With Pneumonia: A Multicenter Observational Study (The MORICUP-PCR Study: Morocco ICU Pneumonia-PCR study).Critical care explorations · 2025Observational
- Guidelines for Antibiotics Prescription in Critically Ill Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- A targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP).Scientific reports · 2024Article
- Impact of Multiplex PCR in the Therapeutic Management of Severe Bacterial Pneumonia.Antibiotics (Basel, Switzerland) · 2024Review
- ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia.Intensive care medicine · 2023Article
- Antibiotic stewardship in the ICU: time to shift into overdrive.Annals of intensive care · 2023Review
- Clinical Efficacy Protocol of Yinhuapinggan Granules: A Randomized, Double-Blind, Parallel, and Controlled Clinical Trial Program for the Intervention of Community-Acquired Drug-Resistant Bacterial Pneumonia as a Complementary Therapy.Frontiers in pharmacology · 2022Article
- A Multicenter Observational Study Evaluating Outcomes Associated With Antibiotic Combination Versus Monotherapy in Patients With Septic Shock.Critical care explorations · 2021Article
- Updates on community acquired pneumonia management in the ICU.Pharmacology & therapeutics · 2021Review
- Meta-analysis of the effects of combination therapies of β-lactams and fluoroquinolones or macrolides in the treatment of community-acquired pneumonia.American journal of translational research · 2021Review
- Hot topics and current controversies in community-acquired pneumonia.Breathe (Sheffield, England) · 2019Review
- Guidelines for Antibiotic Prescription in Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- Appropriate antibiotic management of bacterial lower respiratory tract infections.F1000Research · 2018Review
- Assessment of Treatment of Community Acquired Severe Pneumonia by Two Different Antibiotics.Journal of clinical and diagnostic research : JCDR · 2016Article
- The Value of Macrolide-Based Regimens for Community-Acquired Pneumonia.Current infectious disease reports · 2015Article
Corrections and comments
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Authors and funding
14 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSeveral guidelines recommend initial empirical treatment with two antibiotics instead of one to decrease mortality in community-acquired pneumonia (CAP) requiring intensive-care-unit (ICU) admission. We compared the impact on 60-day mortality of using one or two antibiotics. We also compared the rates of nosocomial pneumonia and multidrug-resistant bacteria.
methodsThis is an observational cohort study of 956 immunocompetent patients with CAP admitted to ICUs in France and entered into a prospective database between 1997 and 2010.
resultsInitial adequate antibiotic therapy was significantly associated with better survival (subdistribution hazard ratio (sHR), 0.63; 95% confidence interval (95% CI), 0.42 to 0.94; P = 0.02); this effect was strongest in patients with Streptococcus pneumonia CAP (sHR, 0.05; 95% CI, 0.005 to 0.46; p = 0.001) or septic shock (sHR: 0.62; 95% CI 0.38 to 1.00; p = 0.05). Dual therapy was associated with a higher frequency of initial adequate antibiotic therapy. However, no difference in 60-day mortality was found between monotherapy (β-lactam) and either of the two dual-therapy groups (β-lactam plus macrolide or fluoroquinolone). The rates of nosocomial pneumonia and multidrug-resistant bacteria were not significantly different across these three groups.
conclusionsInitial adequate antibiotic therapy markedly decreased 60-day mortality. Dual therapy improved the likelihood of initial adequate therapy but did not predict decreased 60-day mortality. Dual therapy did not increase the risk of nosocomial pneumonia or multidrug-resistant bacteria.
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