Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2004 Nov;59(11):960-5.
doi: 10.1136/thx.2003.017756.

Risk factors of treatment failure in community acquired pneumonia: implications for disease outcome

R Menéndez  1 , A Torres, R Zalacaín, J Aspa, J J Martín Villasclaras, L Borderías, J M Benítez Moya, J Ruiz-Manzano, F Rodríguez de Castro, J Blanquer, D Pérez, C Puzo, F Sánchez Gascón, J Gallardo, C Alvarez, L Molinos; Neumofail Group
Affiliations
Multicenter Study

Risk factors of treatment failure in community acquired pneumonia: implications for disease outcome

R Menéndez et al. Thorax. 2004 Nov.

Abstract

Background: An inadequate response to initial empirical treatment of community acquired pneumonia (CAP) represents a challenge for clinicians and requires early identification and intervention. A study was undertaken to quantify the incidence of failure of empirical treatment in CAP, to identify risk factors for treatment failure, and to determine the implications of treatment failure on the outcome.

Methods: A prospective multicentre cohort study was performed in 1424 hospitalised patients from 15 hospitals. Early treatment failure (<72 hours), late treatment failure, and in-hospital mortality were recorded.

Results: Treatment failure occurred in 215 patients (15.1%): 134 early failure (62.3%) and 81 late failure (37.7%). The causes were infectious in 86 patients (40%), non-infectious in 34 (15.8%), and undetermined in 95. The independent risk factors associated with treatment failure in a stepwise logistic regression analysis were liver disease, pneumonia risk class, leucopenia, multilobar CAP, pleural effusion, and radiological signs of cavitation. Independent factors associated with a lower risk of treatment failure were influenza vaccination, initial treatment with fluoroquinolones, and chronic obstructive pulmonary disease (COPD). Mortality was significantly higher in patients with treatment failure (25% v 2%). Failure of empirical treatment increased the mortality of CAP 11-fold after adjustment for risk class.

Conclusions: Although these findings need to be confirmed by randomised studies, they suggest possible interventions to decrease mortality due to CAP.

PubMed Disclaimer

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Clin Ther. 1998 Jul-Aug;20(4):820-37 - PubMed
    1. Rev Esp Quimioter. 1998 Sep;11(3):255-61 - PubMed
    1. JAMA. 1999 Jan 6;281(1):61-6 - PubMed
    1. Crit Care Med. 1999 Sep;27(9):1745-53 - PubMed
    1. Clin Chest Med. 1999 Sep;20(3):623-51 - PubMed

Publication types

Substances

-