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Article

Incidence of Antibiotic Treatment Failure in Patients with Nursing Home-Acquired Pneumonia and Community Acquired Pneumonia

1
Infectious Diseases Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal
2
Nephrology Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal
3
Internal Medicine Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal
*
Authors to whom correspondence should be addressed.
Both authors contributed equally.
Infect. Dis. Rep. 2021, 13(1), 33-44; https://doi.org/10.3390/idr13010006
Received: 29 October 2020 / Revised: 12 December 2020 / Accepted: 14 December 2020 / Published: 5 January 2021
Purpose: Nursing home-acquired pneumonia (NHAP) patients are at higher risk of multi-drug resistant infection (MDR) than those with community-acquired pneumonia (CAP). Recent evidence suggests a single risk factor for MDR does not accurately predict the need for broad-spectrum antibiotics. The goal of this study was to compare the rate antibiotic failure between NHAP and CAP patients. Methods: Demographic characteristics, co-morbidities, clinical and laboratory variables, antibiotic therapy, and mortality data were collected retrospectively for all patients with pneumonia admitted to an Internal Medicine Service between April 2017 and April 2018. Results: In total, 313 of 556 patients had CAP and 243 had NHAP. NHAP patients were older, and were more likely to be dependent, to have recent antibiotic use, and to experience treatment failure (odds ratio (OR) 1.583; 95% CI 1.102–2.276; p = 0.013). In multivariate analysis, patient’s origin did not predict treatment failure (OR 1.083; 95% CI 0.726–1.616; p = 0.696). Discussion: Higher rates of antibiotic failure and mortality in NHAP patients were explained by the presence of other risk factors such as comorbidities, more severe presentation, and age. Admission from a nursing home is not a sufficient condition to start broader-spectrum antibiotics. View Full-Text
Keywords: nursing home-acquired pneumonia; community-acquired pneumonia; antimicrobial drug resistance; epidemiology; treatment failure nursing home-acquired pneumonia; community-acquired pneumonia; antimicrobial drug resistance; epidemiology; treatment failure
MDPI and ACS Style

Lopes, M.; Alves Silva, G.; Nogueira, R.F.; Marado, D.; Gonçalves, J.; Athayde, C.; Silva, D.; Figueiredo, A.; Fortuna, J.; Carvalho, A. Incidence of Antibiotic Treatment Failure in Patients with Nursing Home-Acquired Pneumonia and Community Acquired Pneumonia. Infect. Dis. Rep. 2021, 13, 33-44. https://doi.org/10.3390/idr13010006

AMA Style

Lopes M, Alves Silva G, Nogueira RF, Marado D, Gonçalves J, Athayde C, Silva D, Figueiredo A, Fortuna J, Carvalho A. Incidence of Antibiotic Treatment Failure in Patients with Nursing Home-Acquired Pneumonia and Community Acquired Pneumonia. Infectious Disease Reports. 2021; 13(1):33-44. https://doi.org/10.3390/idr13010006

Chicago/Turabian Style

Lopes, Mariana, Gonçalo Alves Silva, Rui F. Nogueira, Daniela Marado, João Gonçalves, Carlos Athayde, Dilva Silva, Ana Figueiredo, Jorge Fortuna, and Armando Carvalho. 2021. "Incidence of Antibiotic Treatment Failure in Patients with Nursing Home-Acquired Pneumonia and Community Acquired Pneumonia" Infectious Disease Reports 13, no. 1: 33-44. https://doi.org/10.3390/idr13010006

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