ArticleThe Journal of antimicrobial chemotherapy2015
Association of guideline-based antimicrobial therapy and outcomes in healthcare-associated pneumonia.
Article in The Journal of antimicrobial chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.American journal of respiratory and critical care medicine · 2019Guideline
- A model-based cost-effectiveness analysis of Patient Blood Management.Blood transfusion = Trasfusione del sangue · 2019Pooled it
- Mortality after broad- versus narrow-spectrum antibiotic treatment for patients with nursing and healthcare-associated pneumonia: A nationwide retrospective cohort study.Journal of hospital medicine · 2026Article
- Guideline-Concordant Therapy for Community-Acquired Pneumonia in the Hospitalized Population: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2024Article
- No evidence of difference in mortality with amoxicillin versus co-amoxiclav for hospital treatment of community-acquired pneumonia.The Journal of infection · 2024Article
- Methicillin-resistantJournal of the American College of Emergency Physicians open · 2023Article
- Ten Issues to Update in Nosocomial or Hospital-Acquired Pneumonia: An Expert Review.Journal of clinical medicine · 2023Review
- Identify Drug-Resistant Pathogens in Patients with Community-Acquired Pneumonia.Advances in respiratory medicine · 2023Review
- Association Between Empirical Anti-Pseudomonal Antibiotics for Recurrent Lower Respiratory Tract Infections and Mortality: A Retrospective Cohort Study.International journal of chronic obstructive pulmonary disease · 2022Article
- Epidemiology and Outcomes of Community-AcquiredOpen forum infectious diseases · 2022Article
- Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM.Annals of the American Thoracic Society · 2020Article
- Carbapenem Treatment and Outcomes Among Patients With Culture-Positive Complicated Intra-abdominal Infections in US Hospitals: A Retrospective Cohort Study.Open forum infectious diseases · 2019Article
- Reply to Babbel et al., "Application of the DRIP Score at a Veterans Affairs Hospital".Antimicrobial agents and chemotherapy · 2018Article
- A Retrospective Cohort Analysis Shows that Coadministration of Minocycline with Colistin in Critically Ill Patients Is Associated with Reduced Frequency of Acute Renal Failure.Antimicrobial agents and chemotherapy · 2018Article
- Treatment Trends and Outcomes in Healthcare-Associated Pneumonia.Journal of hospital medicine · 2017Article
- Clinical characteristics and prognostic risk factors of healthcare-associated pneumonia in a Korean tertiary teaching hospital.Medicine · 2017Observational
- Carbapenem resistance, inappropriate empiric treatment and outcomes among patients hospitalized with Enterobacteriaceae urinary tract infection, pneumonia and sepsis.BMC infectious diseases · 2017Article
- 30-day readmission, antibiotics costs and costs of delay to adequate treatment of Enterobacteriaceae UTI, pneumonia, and sepsis: a retrospective cohort study.Antimicrobial resistance and infection control · 2017Article
- Health care-associated pneumonia in the intensive care unit: Guideline-concordant antibiotics and outcomes.Journal of critical care · 2016Article
- Multidrug resistance, inappropriate empiric therapy, and hospital mortality in Acinetobacter baumannii pneumonia and sepsis.Critical care (London, England) · 2016Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectivesGuidelines for treatment of healthcare-associated pneumonia (HCAP) recommend empirical therapy with broad-spectrum antimicrobials. Our objective was to examine the association between guideline-based therapy (GBT) and outcomes for patients with HCAP. PATIENTS AND
methodsWe conducted a pharmacoepidemiological cohort study at 346 US hospitals. We included adults hospitalized between July 2007 and June 2010 for HCAP, defined as patients admitted from a nursing home, with end-stage renal disease or immunosuppression, or discharged from a hospital in the previous 90 days. Outcome measures included in-hospital mortality, length of stay and costs.
resultsOf 85 097 patients at 346 hospitals, 31 949 (37.5%) received GBT (one agent against MRSA and at least one against Pseudomonas). Compared with patients who received non-GBT, those who received GBT had a heavier burden of chronic disease and more severe pneumonia. GBT was associated with higher mortality (17.1% versus 7.7%, P < 0.001). Adjustment for demographics, comorbidities, propensity for treatment with GBT and initial severity of disease decreased, but did not eliminate, the association (OR 1.39, 95% CI 1.32-1.47). Using an adaptation of an instrumental variable analysis, GBT was not associated with higher mortality (OR 0.93, 95% CI 0.75-1.16). Adjusted length of stay and costs were also higher with GBT.
conclusionsAmong patients who met HCAP criteria, GBT was not associated with lower adjusted mortality, length of stay or costs in any analyses. Better criteria are needed to identify patients at risk for MDR infections who might benefit from broad-spectrum antimicrobial coverage.
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