Comparison of mortality benefit using standardized treatment in Community Acquired Pneumonia.

Background: 

Pneumonia is one the most common causes of hospital admissions exceeding more than a million per year, contributing to 3.4% of inpatient mortality. Therefore, it is important to determine the best therapy to improve outcomes. Our objective was to compare 30 day mortality benefit using ceftriaxone plus azithromycin to fluoroquinolones for treatment of CAP.

Methods:

A multicenter retrospective analysis from 4 different hospitals was assessed from 2002 to 2013. The data was obtained from electronic medical records which included more than 70,000 patients. CAP patients were identified using diagnostic codes. Demographic data, therapy and Charlson score was obtained to compare the study groups.

Results:

Total of 21, 800 patients met our inclusion criteria for CAP but 1,740 were excluded as they received both beta lactams and fluoroquinolones within first 24 hours. The study included 20, 600 patients, 11, 201 (55.84%) received ceftriaxone with azithromycin and 8, 859(44.16%) received fluoroquinolone therapy. The mortality rate for patients who received fluoroquinolone therapy was lower compared to the patients who received ceftriaxone plus azithromycin (3.56% vs 6.71%, p-value <0.001).

Conclusion:

Our study showed statistically significant lower 30 day mortality using fluoroquinolone therapy compared to ceftriaxone plus azithromycin for treatment of CAP. Further randomized control trials would be needed to support this evidence.