Top

Published in:

01-04-2010 | Editorial

Are macrolides now obligatory in severe community-acquired pneumonia?

Author: Grant W. Waterer

Published in: Intensive Care Medicine | Issue 4/2010

Excerpt

In this issue of Intensive Care Medicine, Martin-Loeches and colleagues [1] present an analysis of a cohort of 218 patients with community-acquired pneumonia requiring mechanical ventilation enrolled into a larger, observational, multi-center European study. The major finding of the study in this issue was that the 42 patients who received a macrolide antibiotic had half the mortality rate of other patients after adjusting for severity of illness at presentation. …

Martin-Loeches I, Lisboa T, Rodriguez A, Putensen C, Annane D, Restrepo MI, Garnacho-Montero J, Rello J (2009) Combination antibiotic therapy with macrolides improves survival in patients with severe community-acquired pneumonia. Intensive Care Med. doi: 10.1007/s00134-009-1730-y

Mufson MA, Stanek RJ (1999) Bacteremic pneumococcal pneumonia in one American city: a 20-year longitudinal study, 1978–1997. Am J Med 107:34S–43SCrossRefPubMed

Waterer GW, Somes GW, Wunderink RG (2001) Monotherapy may be suboptimal for severe bacteremic pneumococcal pneumonia. Arch Intern Med 161:1837–1842CrossRefPubMed

Baddour LM, Yu VL, Klugman KP, Feldman C, Ortqvist A, Rello J, Morris AJ, Luna CM, Snydman DR, Ko WC, Chedid MB, Hui DS, Andremont A, Chiou CC (2004) Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia. Am J Respir Crit Care Med 170:440–444CrossRefPubMed

Martinez JA, Horcajada JP, Almela M, Marco F, Soriano A, Garcia E, Marco MA, Torres A, Mensa J (2003) Addition of a macrolide to a beta-lactam-based empirical antibiotic regimen is associated with lower in-hospital mortality for patients with bacteremic pneumococcal pneumonia. Clin Infect Dis 36:389–395CrossRefPubMed

Rodriguez A, Mendia A, Sirvent JM, Barcenilla F, de la Torre-Prados MV, Sole-Violan J, Rello J (2007) Combination antibiotic therapy improves survival in patients with community-acquired pneumonia and shock. Crit Care Med 35:1493–1498CrossRefPubMed

Restrepo MI, Mortensen EM, Waterer GW, Wunderink RG, Coalson JJ, Anzueto A (2009) Impact of macrolide therapy on mortality for patients with severe sepsis due to pneumonia. Eur Respir J 33:153–159CrossRefPubMed

Zambon A, Polo Friz H, Contiero P, Corrao G (2009) Effect of macrolide and fluoroquinolone antibacterials on the risk of ventricular arrhythmia and cardiac arrest: an observational study in Italy using case-control, case-crossover and case-time-control designs. Drug Saf 32:159–167CrossRefPubMed

Mortensen EM RM, Anzueto A, Pugh J (2006) The impact of empiric antimicrobial therapy with a beta-lactam and fluroquinolone on mortality for patients with severe pneumonia. Crit Care

10.

Metersky ML, Ma A, Houck PM, Bratzler DW (2007) Antibiotics for bacteremic pneumonia: improved outcomes with macrolides but not fluoroquinolones. Chest 131:466–473CrossRefPubMed

11.

Parnham MJ (2005) Immunomodulatory effects of antimicrobials in the therapy of respiratory tract infections. Curr Opin Infect Dis 18:125–131CrossRefPubMed

12.

Rello J, Lisboa T, Lujan M, Gallego M, Kee C, Pryce TM, Waterer GW (2009) Adverse clinical outcomes from pneumococcal pneumonia are predicted by quantitative bacterial load in blood at presentation to the emergency department. Chest in press

13.

Anderson R, Steel HC, Cockeran R, von Gottberg A, de Gouveia L, Klugman KP, Mitchell TJ, Feldman C (2007) Comparison of the effects of macrolides, amoxicillin, ceftriaxone, doxycycline, tobramycin and fluoroquinolones, on the production of pneumolysin by Streptococcus pneumoniae in vitro. J Antimicrob Chemother 60:1155–1158CrossRefPubMed

14.

Giamarellos-Bourboulis EJ, Baziaka F, Antonopoulou A, Koutoukas P, Kousoulas V, Sabracos L, Panagou C, Perrea D, Giamarellou H (2005) Clarithromycin co-administered with amikacin attenuates systemic inflammation in experimental sepsis with Escherichia coli. Int J Antimicrob Agents 25:168–172CrossRefPubMed

15.

Cirioni O, Ghiselli R, Silvestri C, Kamysz W, Orlando F, Riva A, Kamysz E, Castelletti S, Rocchi M, Saba V, Scalise G, Giacometti A (2008) Efficacy of the combination of tachyplesin III and clarithromycin in rat models of Escherichia coli sepsis. Antimicrob Agents Chemother 52:4351–4355CrossRefPubMed

16.

Giamarellos-Bourboulis EJ, Pechere JC, Routsi C, Plachouras D, Kollias S, Raftogiannis M, Zervakis D, Baziaka F, Koronaios A, Antonopoulou A, Markaki V, Koutoukas P, Papadomichelakis E, Tsaganos T, Armaganidis A, Koussoulas V, Kotanidou A, Roussos C, Giamarellou H (2008) Effect of clarithromycin in patients with sepsis and ventilator-associated pneumonia. Clin Infect Dis 46:1157–1164CrossRefPubMed

Title: Are macrolides now obligatory in severe community-acquired pneumonia?
Author: Grant W. Waterer
Publication date: 01-04-2010
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 4/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1734-7

At a glance: The STEP trials

Springer Medicine

Are macrolides now obligatory in severe community-acquired pneumonia?

Excerpt

At a glance: The STEP trials

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 4/2010

Combination antibiotic therapy with macrolides improves survival in intubated patients with community-acquired pneumonia

Plasma citrulline kinetics and prognostic value in critically ill patients

Must we always follow the instructions of automated external defibrillators?

Erratum to: Prevention of acute kidney injury and protection of renal function in the intensive care unit

Bilevel positive airway pressure ventilation: factors influencing carbon dioxide rebreathing

The long way of biomarkers: from bench to bedside