Chokshi R, Restrepo M I, Weeratunge N, Frei C R, Anzueto A, Mortensen E M
Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284, USA.
Eur J Clin Microbiol Infect Dis. 2007 Jul;26(7):447-51. doi: 10.1007/s10096-007-0307-3.
The purpose of this study was to examine the impact of antimicrobial monotherapy vs combination therapy on length of stay and mortality for patients with Streptococcus pneumoniae pneumonia. Thirty-nine percent of patients received monotherapy, while 61% received combination therapy. Although there was no significant difference in mortality (OR 1.25, 95% CI = 0.25-6.8), there was a significant increase in length of stay for patients who received combination therapy (p = 0.02). Patients with bacteremic pneumococcal pneumonia treated with empiric combination therapy had no significant difference in mortality; however, they did have increased length of stay after adjusting for severity of illness. Randomized controlled trials are needed to determine what is the optimal empiric antimicrobial regime for patients with community-acquired pneumonia.
本研究的目的是探讨抗菌单药治疗与联合治疗对肺炎链球菌肺炎患者住院时间和死亡率的影响。39%的患者接受了单药治疗，而61%的患者接受了联合治疗。尽管死亡率没有显著差异（比值比1.25，95%置信区间=0.25 - 6.8），但接受联合治疗的患者住院时间显著延长（p = 0.02）。经验性联合治疗的菌血症性肺炎患者死亡率无显著差异；然而，在调整疾病严重程度后，他们的住院时间确实延长了。需要进行随机对照试验来确定社区获得性肺炎患者的最佳经验性抗菌治疗方案。
