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Table 3 Comparison of the groups given monotherapy and dual therapy

From: Initial use of one or two antibiotics for critically ill patients with community-acquired pneumonia: impact on survival and bacterial resistance

  Monotherapy (β-lactam) Dual therapy
Parameters Total population (n = 471) Total population (n = 394) β-lactam + Macrolide (n = 164) β-lactam + Fluoroquino-lone (n = 230)
Variables at admission     
Male, n (%) 301 (63.9) 274 (69.5) 110 (67.1) 164 (71.3)
Age in years, median [IQR] 60 [45; 75] 64 [48; 77] 64 [49; 79] 64 [47; 76]
Scores, n (%)     
SAPSII*£ 47 [34; 60] 39.5 [28; 57] 37 [28.5; 51] 43[28; 63]
SOFA score£ 6 [4; 9] 6 [3; 9] 5 [3; 8] 7 [4; 10]
LOD score*£ 5 [3; 7] 4 [2; 7] 3 [2; 5.5] 4 [2; 8]
Coma Glasgow Scale*£ 8 [4; 15] 15 [8.5; 15] 15 [11;15] 14 [7; 15]
McCabe, n (%)     
1 326 (69.2) 284 (72.4) 119 (73.5) 165 (71.7)
2 124 (26.3) 98 (25.0) 40 (24.7) 58 (25.2)
3 21 (4.5) 10 (2.6) 3 (1.9) 7 (3.0)
CURB-65,* n (%)     
0 3 (0.6) 7 (1.8) 1 (0.6) 6 (2.6)
1 20 (4.2) 38 (9.6) 15 (9.1) 23 (10.0)
2 88 (18.7) 71 (18.0) 34 (20.7) 37 (16.1)
3 157 (33.3) 107 (27.2) 42 (25.6) 65 (28.3)
4 122 (25.9) 107 (27.2) 46 (28.0) 61 (26.5)
5 81 (17.2) 64 (16.2) 26 (15.9) 38 (16.5)
Co-morbidities (Knaus definitions), n (%)
Chronic hepatic failure£ 23 (4.9) 17 (4.3) 3 (1.8) 14 (6.1)
Chronic heart failure 47 (10.0) 48 (12.2) 25 (15.2) 23 (10.0)
Chronic respiratory failure*£ 65 (13.8) 86 (21.8) 52 (31.7) 34 (14.8)
Chronic renal failure 9 (1.9) 7 (1.8) 3 (1.8) 4 (1.7)
Diabetes 58 (12.3) 48 (12.2) 16 (9.8) 32 (13.9)
≥One co-morbidity* 153 (32.5) 161 (40.9) 75 (45.7) 86 (37.4)
Smokers (>20 pack-years), n (%) 114 (31.1) 97 (28.1) 41 (29.3) 56 (27.3)
Alcohol (>80 g/d)* n (%) 101 (27.6) 73 (21.2) 31 (22.1) 42 (20.5)
Sepsis, n (%) 458 (97.2) 383 (97.2) 158 (96.3) 225 (97.8)
Severe sepsis, n (%) * 395 (83.9) 360 (91.4) 146 (89) 214 (93.0)
Septic shock, n (%)* 146 (31.0) 152(38.6) 55 (33.5) 97(42.2)
Treatments, n (%) unless otherwise stated
Invasive ventilation*£ 340 (72.2) 207 (52.5) 73 (44.5 134 (58.3)
Noninvasive ventilation* 40 (8.5) 58 (14.7) 27 (16.5) 31 (13.5)
Inotropes or vasoactive agents*£ 189 (40.1) 191 (48.5) 67 (40.9) 124 (53.9)
Corticosteroids* 69 (14.6) 96 (24.4) 40 (24.4) 56 (24.3)
Hemodialysis/Hemofil-tration 23 (4.9) 31 (7.9) 11 (637) 20 (8.7)
Antibiotic therapy duration in days, median [IQR]* 7 [4; 13] 8 [4; 14] 7 [4; 13] 8 [4; 15]
Organisms, n (%)     
Streptococcus pneumoniae* £ 125 (26.5) 69 (17.5) 42 (25.6) 27 (11.7)
Staphylococcus aureus* £ 65 (13.8) 25 (6.3) 5 (3.0) 20 (8.7)
Streptococcus spp. 22 (4.7) 9 (2.3) 2 (1.2) 7 (3.0)
Enterocococcus spp. 3 (0.6) 0 (0) 0 (0) 0 (0)
Hemophilus influenzae* 57 (12.1) 29 (7.4) 15 (9.1) 14 (6.1)
Klebsiella pneumoniae 16 (3.4) 8 (2.0) 3 (1.8) 5 (2.2)
Escherichia coli 23 (4.9) 10 (2.5) 2 (1.2) 8 (3.5)
Enterobacteriaceae spp.* 11 (2.3) 2 (0.5) 1 (0.6) 1 (0.4)
Serratia marescens 3 (0.6) 1 (0.3) 0 (0) 1 (0.4)
Proteus mirabilis 7 (1.5) 1 (0.3) 0 (0) 1 (0.4)
Pseudomonas aeruginosa 13 (2.8) 14 (3.6) 5 (3.0) 9 (3.9)
Legionella pneumophila* 1 (0.2) 9 (2.3) 5 (3.0) 4 (1.7)
Mycoplasma pneumoniae 0 (0) 0 (0) 0 (0) 0 (0)
Chlamydia pneumoniae 0 (0)) 2 (0.5) 0 (0) 2 (0.9)
Mycobacterium tuberculosis £ 3 (0.6) 6 (1.5) 5 (3.0) 1 (0.4)
Aspergillus fumigatus 0 (0) 3 (0.8) 2 (1.2) 1 (0.4)
Viruses* 6 (1.3) 15 (3.8) 7 (4.3) 8 (3.5)
Other 6 (1.3) 6 (1.5) 1 (06) 5 (2.2)
Multiple organisms* 62 (13.2) 22 (5.6) 8 (4.9) 14 (6.1)
None identified* 182 (38.6) 207 (52.5) 77 (47.0) 130 (56.5)
Bacteremia* 74 (15.7) 42 (10.7) 15 (9.1) 27 (11.7)
Acquisition of MDR pathogens or nosocomial pneumonia, n (%)
MDR bacteria 52 (11.0) 44 (11.2) 19 (11.6) 25 (10.9)
MRSA 12 (2.5) 12 (3.0) 5 (3.0) 7 (3)
Enterobacteriaceae ESBL 22 (4.7) 12 (3.0) 5 (3.0) 7 (3)
Nonfermentative GNB 25 (5.3) 25 (6.3) 14 (8.5) 11 (4.8)
Clostridium difficile 6 (1.3) 2 (0.5) 0 (0) 2 (0.9)
Nosocomial pneumonia 58 (12.3) 54 (13.7) 23 (14) 31 (13.5)
ICU stay in days, median [IQR] 6 [3; 15] 7 [3; 16] 7 [3.5; 15.5] 8 [3; 17]
Hospital stay in days, median [IQR] 15 [8; 33] 18 [10; 31] 17.5 [10.5; 35] 18 [9; 30]
Patients who died within 60 days, £ n (%) 123 (26.1) 107 (27.2) 35 (21.3) 72 (31.3)
  1. ESBL, extended-spectrum beta-lactamase; LOD, Logistic Organ Dysfunction Score; MDR, multidrug resistant; MRSA, methicillin-resistant Staphylococcus aureus; Nonfermentative GNB, nonfermentative Gram-negative bacilli (Pseudomonas spp., Acinetobacter baumannii, Stenotrophomonas maltophilia).
  2. *P <0.05 for monotherapy (n = 471) versus dual therapy (n = 394); £P <0.05 for β-lactam + macrolide (n = 164) vs. β-lactam + fluoroquinolone (n = 230).
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Critical Care

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