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IDWeek 2013: Avoid Broad-Spectrum Antibiotics for CAP

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The Particulars: Patients with severe community-acquired pneumonia (CAP) often receive broad-spectrum antibiotics despite limited evidence supporting this practice . Few analyses have explored outcomes of CAP patients who receive broad-spectrum antibiotics and compared them with similar patients treated with therapeutic regimens recommended with guidelines from the Infectious Disease Society of America (IDSA).

Data Breakdown: A retrospective review analyzed data on patients with CAP who were treated with broad-spectrum antibiotics or IDSA guideline-recommended treatment regimens. Those receiving IDSA guideline-recommended treatments fared better in all studied outcomes, including intravenous and total days on therapy, ICU and total hospital lengths of stay, and 30-day readmission. Recipients of IDSA guideline-recommended therapies also had better outcomes with regard to ventilated days, acute kidney injury, Clostridium difficile infection, and Candida super infection. Patients treated with broad-spectrum antibiotics had a 30-day mortality rate of 16.1%, compared with a 6.4% rate for those receiving IDSA guideline-recommended treatments.

Take Home Pearls: Use of broad-spectrum antibiotics in patients with CAP appears to result in worse outcomes than treatment with IDSA guideline-recommended treatment regimens.

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