Community-acquired pneumonia: a comparison of clinical treatment failure in patients treated with either penicillin or cefuroxime

Ekloef and Schmidt Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine2012, 20(Suppl 2):P10http://www.sjtrem.com/content/20/S2/P10 Community-acquired pneumonia: a comparisonof clinical treatment failure in patients treatedwith either penicillin or cefuroximeJosefin Ekloef*, Thomas A Schmidt From 4th Danish Emergency Medicine ConferenceRoskilde, Denmark. 25-26 November 2011 cefuroxime. Forty percent of the patients treated with National and local guidelines in the Emergency depart- penicillin experienced CTF compared to 17% in the ment (ED) at Holbaek hospital recommend penicillin as group treated with cefuroxime (p=0.347). Patients were first-line treatment of community-acquired pneumonia followed for 9 days. At 5 days, a survival rate without (CAP). Nevertheless, the use of cefuroxime seem to be CTF was estimated to 0,75 for cefuroxime and 0.54 for substantial when admitting patients with CAP.
penicillin. There was no significant difference between The aim of this study was to document the use of the treatment groups (logrank test: p=0.227). No further penicillin and cefuroxime as initial treatment of CAP, and to compare clinical treatment failure (CTF) in thetwo groups.
ConclusionCefuroxime was the most common choice of treatment for CAP. Thus, treatment of CAP at Holbaek hospital Data was collected by finding medical records of does not adhere to national or local guidelines. How- patients discharged from Holbaek hospital with a princi- ever, numerically the results may indicate a higher rate pal diagnosis of CAP in the period January-March 2010.
of CTF in patients treated with penicillin compared to A total number of 50 patients were assessed. Patients < cefuroxime. This need not to be a mere play of chance.
18 years (n=0), with chronic obstructive pulmonary dis- A prospective study with a higher number of observa- ease (COPD) (n=17), in immune-suppressive treatment (n=4), and receiving other antibiotic as mono therapy(n=2) or as combination therapy (n=5) were excluded.
CTF was defined as change of therapy due to unre- sponsiveness. Kaplan-Meier plot was used to estimatetime until CTF (e.g. end-point) and probability of CTFbetween the groups. Time to CTF was defined as days Cite this article as: Ekloef and Schmidt: Community-acquired from initial therapy to change. Patients dying (n=2) or pneumonia: a comparison of clinical treatment failure in patients being discharged without CTF (n=14) were censored at treated with either penicillin or cefuroxime. Scandinavian Journal ofTrauma, Resuscitation and Emergency Medicine 2012 20(Suppl 2):P10.
ResultsAll patients were treated with antibiotics intravenously.
Treatment was initiated in the ED in 77% of the cases.
Fifty-five percent of all patients were treated with * Correspondence: Department of Emergency Medicine, Holbaek Hospital, Denmark 2012 Ekloef and Schmidt; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License ), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited.

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