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Vol. 42. Issue 9.
Pages 430-433 (September 2006)
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Vol. 42. Issue 9.
Pages 430-433 (September 2006)
Original Articles
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Treatment and Course of Community-Acquired Pneumonia Caused by Atypical Pathogens
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Ramón Fernández Álvarez
Corresponding author
enelllano@terra.es

Correspondence: Dr. R. Fernández Álvarez. San Juan Bautista, 19, A. 38002 Santa Cruz de Tenerife. España
, Isabel Suárez Toste, Gemma Rubinos Cuadrado, Agustín Medina Gonzálvez, José Antonio Gullón Blanco, Isidro González Martín
Servicio de Neumología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
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Objective

To study the course of disease and outcomes in a group of patients with community-acquired pneumonia caused by atypical pathogens (Mycoplasma pneumoniae, Legionella species, Coxiella burnetii, and Chlamydophila pneumoniae) according to the empiric treatment received.

Patients and methods

Of a total of 390 patients admitted to our hospital with pneumonia between January 1996 and February 2001, the causative microorganism was an atypical pathogen in 89 cases. Patients were divided retrospectively into 2 groups according to the empiric treatment they received: group A, who had received an antibiotic regimen (quinolones or macrolides) that provided coverage for atypical pathogens; and group B, who had received treatment that did not provide such coverage. Clinical course was assessed in terms of the differences between the 2 groups in length of hospital stay, radiographic resolution, readmission at 30 days after discharge, and mortality.

Results

A total of 89 patients with pneumonia caused by atypical pathogens (39 in group A and 50 in group B) were studied. No significant between-group differences in the variables were found.

Conclusions

In this group of patients hospitalized for community-acquired pneumonia, antibiotic regimens providing coverage for atypical pathogens did not improve either clinical or radiographic evolution.

Key words:
Antibiotic treatment for pneumonia
Community-acquired pneumonia
A typical pneumonia
Objetivo

Estudiar la evolución de un grupo de neumonías extrahospitalarias causadas por gérmenes atípicos (Mycoplasma pneumoniae, Legionella spp., Coxiella burnetii y Chlamydophila pneumoniae) en función del tratamiento empírico recibido.

Pacientes y métodos

Entre enero de 1996 y febrero de 2001 ingresaron en nuestra unidad 390 casos de neumonía, de los que 89 estaban causados por gérmenes atípicos. Los pacientes se dividieron retrospectivamente en 2 grupos según el tratamiento empírico pautado: grupo A, al que se había proporcionado cobertura frente a gérmenes atípicos (quinolonas o macrólidos), y grupo B, al que no se había proporcionado dicha cobertura. Se estudió la evolución según las diferencias entre ambos grupos en la estancia hospitalaria, la resolución radiológica, el reingreso en el primer mes tras el alta y la mortalidad.

Resultados

El grupo de estudio lo constituyeron 89 pacientes con neumonía causada por gérmenes atípicos (39 en el grupo A y 50 en el B). Las variables estudiadas no mostraron diferencias significativas entre ambos grupos.

Conclusiones

En nuestra serie de neumonías extrahospitalarias la cobertura antibiótica frente a gérmenes atípicos no mejoró la evolución clínica y radiológica de los pacientes.

Palabras clave:
Tratamiento antibiótico de la neumonía
Neumonía adquirida en la comunidad
Neumonía atípica
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References
[1]
American Thoracic Society.
Guidelines for the management of adults with community-acquired pneumonia.
Am J Respir Crit Care Med., 163 (2001), pp. 1730-1754
[2]
Dorca J, Bello S, Blanquer J, de Cellis R, Molinos L, Torres A, et al.
Diagnóstico y tratamiento de la neumonía adquirida en la comunidad.
Arch Bronconeumol, 33 (1997), pp. 240-246
[3]
British Thoracic Society.
Guidelines for the management of community-acquired pneumonia in adults.
Thorax, 56 (2001), pp. 1-64
[4]
Grupo de Trabajo de la Asociación Latinoamericana del Tórax (ALAT).
Actualización de las recomendaciones ALAT sobre la neumonía adquirida en la comunidad.
Arch Bronconeumol, 40 (2004), pp. 364-374
[5]
Örtqvist A.
Treatment of community-acquired lower respiratory tract infections in adults.
Eur Respir J., 36 (2002), pp. 40-53
[6]
Molinos L.
Importancia de la etiología polimicrobiana en la neumonía.
Arch Bronconeumol, 39 (2003), pp. 22-26
[7]
File TM, Garau J, Blasi F, Chidiac C, Klusman K, Code H, et al.
Guidelines for empiric antimicrobial prescribing in community-acquired pneumonia.
Chest, 125 (2004), pp. 1888-1901
[8]
Fine MJ, Auble TE, Yealy D, Hanusa BH, Weissfeld LA, Singer DE, et al.
A prediction rule to identify low-risk patients with community-acquired pneumonia.
N Engl J Med., 336 (1997), pp. 243-250
[9]
Marrie TJ.
Deaths in risk classes I-III: a measure of quality of care in patients hospitalised with CAP?.
Eur Respir J., 23 (2004), pp. 103-105
[10]
Stahl JA, Barza M, DesJardin J, Martin R, Eckman MH.
Effect of macrolides as part of initial empiric therapy on length of stay in patients hospitalized with community-acquired pneumonia.
Arch Inter Med., 159 (1999), pp. 2576-2580
[11]
Gleason PP, Meehan TP, Fine JM, Galusha DH, Fine MJ.
Associations between initial antimicrobial therapy and medical outcomes for hospitalized elderly patients with pneumonia.
Arch Intern Med., 159 (1999), pp. 2562-2572
[12]
Fernández R, Gullón JA, Rubinos G, Jiménez A, Medina A, Hernández C, et al.
Neumonía adquirida en la comunidad: influencia de la duración de la antibioterapia intravenosa en la estancia hospitalaria y relación coste/efectividad.
Arch Bronconeumol, 37 (2001), pp. 366-370
[13]
Capelastegui A, España PP, Quintana JM, Gorordo I, Martínez Urquiri A, Idoiaga I, et al.
Pacientes ingresados por neumonía adquirida en la comunidad: estudio comparativo en función de la especialidad del servicio médico responsable.
Arch Bronconeumol, 41 (2005), pp. 300-306
[14]
Menéndez R, Torres A.
Neumonía: predecir la mala evolución.
Arch Bronconeumol, 41 (2005), pp. 475-477
[15]
Mundy LM, Oldach D, Auwaerter PG, Gaydos CA, Moore RD, Bartlett JG, et al.
Implications for macrolide treatment in community-acquired pneumonia.
Chest, 113 (1998), pp. 1201-1206
[16]
Barton K, Nicholls DP, Stanford CF, Connolly JH, Wilson TS.
Which atypical pneumonia?.
J Infect., 19 (1989), pp. 294-297
[17]
Rubin BK, Henke MO.
Immunomodulatory activity and effectiveness of macrolides in chronic airway disease.
Chest, 125 (2004), pp. 70-78
[18]
Baddour LM, Yu VL, Klugman KP, Feldman C, Ortqvist A, Rello J, et al.
Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia.
Am J Respir Crit Care Med., 170 (2004), pp. 440-444
[19]
Woodhead M.
Community-acquired pneumonia in Europe: causative pathogens and resistance patterns.
Eur Respir J., 20 (2002), pp. 20-27
[20]
Mills GD, Oehley MR, Arrol B.
Effectiveness of beta-lactam antibiotics compared with antibiotics active against atypical pathogens in non-severe community acquired pneumonia: meta-analysis.
[21]
Garau J.
Role of beta-lactam agents in the treatment of community-acquired pneumonia.
Eur J Clin Microbiol Infect Dis., 24 (2005), pp. 83-99
[22]
Grupo de Estudio de la Neumonía Adquirida en la Comunidad.
Área de Tuberculosis e Infecciones Respiratorias (TIR). Normativa para el diagnóstico y tratamiento de la neumonía adquirida en la comunidad.
Arch Bronconeumol, 41 (2005), pp. 272-289
Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
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