ArticleJournal of hospital medicine2026
Mortality after broad- versus narrow-spectrum antibiotic treatment for patients with nursing and healthcare-associated pneumonia: A nationwide retrospective cohort study.
Article in Journal of hospital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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Who cites it
1 citing paper in PubMed.
- 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
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5 authors.
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Abstract
backgroundNursing and healthcare-associated pneumonia (NHCAP) is defined as pneumonia occurring in individuals with frequent healthcare contact, such as residents of care facilities or patients with impaired activities of daily living. The effectiveness of broad-spectrum antibiotics in treating NHCAP remains unclear.
objectiveTo compare clinical outcomes between broad- and narrow-spectrum antibiotic treatments in patients with NHCAP using a nationwide inpatient database.
methodsPatients diagnosed with NHCAP between April 2014 and March 2022 were identified from the Diagnosis Procedure Combination inpatient database in Japan. Patients were categorised into those receiving broad-spectrum antibiotics (antipseudomonal penicillins, antipseudomonal cephalosporins, and carbapenems) and those receiving narrow-spectrum antibiotics (third-generation cephalosporins and penicillin plus β-lactamase inhibitor combinations). Instrumental variable analysis using hospital preference for broad-spectrum antibiotics was conducted to compare 30-day in-hospital mortality. A subgroup analysis was performed for patients with ≥3 risk factors for antibiotic-resistant pathogens.
resultsAmong 828,283 eligible patients, 24.8% received broad-spectrum antibiotics, while 75.2% received narrow-spectrum antibiotics. Instrumental variable analysis showed that broad-spectrum antibiotic use was not associated with 30-day in-hospital mortality (10.0% vs. 10.0%; risk difference, 0.0%; 95% confidence interval, -0.7% to 0.8%) compared with narrow-spectrum antibiotic use. The subgroup analysis of patients with three or more risk factors for antibiotic-resistant pathogens, broad-spectrum antibiotic use was also not associated with 30-day mortality (10.5% vs. 11.0%; risk difference, -0.6%; 95% confidence interval, -2.5% to 1.3%).
conclusionsBroad-spectrum antibiotic use was not associated with short-term in-hospital mortality in patients with NHCAP, underscoring the importance of individualized antibiotic selection based on patient-specific risk factors.
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