open access

Vol 89, No 4 (2021)
Research paper
Submitted: 2021-01-17
Accepted: 2021-03-27
Published online: 2021-07-16
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Risk factors for complicated community-acquired pneumonia course in patients treated with β-lactam monotherapy

Giedrė Cincilevičiūtė12, Vaida Averjanovaitė2, Rūta Mereškevičienė2, Gabrielė Pliatkienė23, Rolandas Zablockis12, Edvardas Danila12
DOI: 10.5603/ARM.a2021.0070
·
Pubmed: 34269401
·
Adv Respir Med 2021;89(4):359-368.
Affiliations
  1. Clinic of Chest Diseases, Immunology and Allergology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
  2. Centre of Pulmonology and Allergology of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
  3. Faculty of Medicine, Vilnius University, Vilnius, Lithuania

open access

Vol 89, No 4 (2021)
ORIGINAL PAPERS
Submitted: 2021-01-17
Accepted: 2021-03-27
Published online: 2021-07-16

Abstract

Introduction: We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with b-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course. Material and methods: A prospective observational study was conducted at the Pulmonology and Allergology Department in a tertiary care university hospital. 253 consecutive patients diagnosed with CAP requiring hospitalisation were enrolled. Hospital admission was based on PSI or CRB-65 scores, severe comorbidities, signs of intoxication, aspiration risk, social risk consider-ations, ineffective prior antibiotic treatment. Results: Fourty seven percent of the subjects had complications on admission, 13% developed new CAP complications during inpatient treatment. Overall, 53% of individuals had a complicated CAP course. 30-day mortality rate was 5.9%. The factors predicting a complicated CAP course were as follows: neuromuscular disease, multilobar opacities on chest X-ray (or computed tomography), and clinically unstable condition as evaluated using Halm’s criteria. Conclusions: The mortality rate in CAP patients treated with b-lactam monotherapy is low. Neuromuscular disease, multilobar opacities, and clinically unstable condition as evaluated using Halm’s criteria predict a complicated CAP course.

Abstract

Introduction: We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with b-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course. Material and methods: A prospective observational study was conducted at the Pulmonology and Allergology Department in a tertiary care university hospital. 253 consecutive patients diagnosed with CAP requiring hospitalisation were enrolled. Hospital admission was based on PSI or CRB-65 scores, severe comorbidities, signs of intoxication, aspiration risk, social risk consider-ations, ineffective prior antibiotic treatment. Results: Fourty seven percent of the subjects had complications on admission, 13% developed new CAP complications during inpatient treatment. Overall, 53% of individuals had a complicated CAP course. 30-day mortality rate was 5.9%. The factors predicting a complicated CAP course were as follows: neuromuscular disease, multilobar opacities on chest X-ray (or computed tomography), and clinically unstable condition as evaluated using Halm’s criteria. Conclusions: The mortality rate in CAP patients treated with b-lactam monotherapy is low. Neuromuscular disease, multilobar opacities, and clinically unstable condition as evaluated using Halm’s criteria predict a complicated CAP course.

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Keywords

community-acquired pneumonia; β-lactam monotherapy; mortality; complications.

About this article
Title

Risk factors for complicated community-acquired pneumonia course in patients treated with β-lactam monotherapy

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 4 (2021)

Article type

Research paper

Pages

359-368

Published online

2021-07-16

DOI

10.5603/ARM.a2021.0070

Pubmed

34269401

Bibliographic record

Adv Respir Med 2021;89(4):359-368.

Keywords

community-acquired pneumonia
β-lactam monotherapy
mortality
complications.

Authors

Giedrė Cincilevičiūtė
Vaida Averjanovaitė
Rūta Mereškevičienė
Gabrielė Pliatkienė
Rolandas Zablockis
Edvardas Danila

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