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Lack of effect of combination antibiotic therapy on mortality in patients with pneumococcal sepsis

Harbarth, S. ; Garbino, J. ; Pugin, J. ; Romand, J. ; Pittet, D.

In: European Journal of Clinical Microbiology and Infectious Diseases, 2005, vol. 24, no. 10, p. 688-690

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    Titre
    • Lack of effect of combination antibiotic therapy on mortality in patients with pneumococcal sepsis
    Auteur
    • Harbarth, S.. Division of Infectious Diseases, University of Geneva Hospitals, Geneva, Switzerland
    • Garbino, J.. Division of Infectious Diseases, University of Geneva Hospitals, Geneva, Switzerland
    • Pugin, J.. Division of Medical and Surgical Intensive Care, University of Geneva Hospitals, Geneva, Switzerland
    • Romand, J.. Division of Medical and Surgical Intensive Care, University of Geneva Hospitals, Geneva, Switzerland
    • Pittet, D.. Division of Infectious Diseases, University of Geneva Hospitals, Geneva, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Clinical Microbiology and Infectious Diseases, 2005, vol. 24, no. 10, p. 688-690. Springer-Verlag
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:317739
    Summary
    In order to determine whether combination antibiotic therapy decreases mortality after severe pneumococcal infection, a retrospective study of a cohort of 1,840 adult patients with severe sepsis or septic shock enrolled in two multicenter clinical trials between 1994 and 1999 was conducted. Among 107 patients with monobacterial pneumococcal sepsis, the case-fatality rate was 20% (five of 25) for patients who received antibiotic monotherapy compared with 19.5% (16 of 82) for patients who received combination therapy (adjusted hazard ratio, 1.1; 95% CI, 0.4-3.1). Similarly, monotherapy did not increase the risk of death (adjusted hazard ratio, 1.0; 95% CI, 0.2-4.8) among bacteremic patients (n=75). However, the latter analysis may have been underpowered (power, 58%) to detect a difference in mortality. Overall, in contrast to recently published reports, these results suggest that combination antibiotic therapy does not decrease mortality after severe pneumococcal sepsis