Respiratory Fluoroquinolones vs. Other Commonly Used Antimicrobials in Mild-to-Moderate Severity Community-Acquired Pneumonia

Abstract

 

Objective

Respiratory Fluoroquinolones (RFQs) are widely used in the treatment of community-acquired pneumonia (CAP) in our part of the world. Our aim was to find if there was outcome difference between RFQ-based versus RFQ-exempt regimens.

Methods

A retrospective study of RFQs versus other commonly used antimicrobial therapy (OUAT) in the treatment of patients with mid-to-moderate CAP adjusted by pneumonia severity score (PSI). Rates of treatment outcome at end-of- therapy i.e. clinical improvement, length of hospital stay and speed of recovery were evaluated. Patients were included if they had Mild-to-Moderate severity CAP, ≥18 years old, completed ≥ 3 days of antimicrobials.

Results

320 patients were included, mean age for all groups was 49.63 years (P = 0.204), males 60.3 % (P = 0.219). All had similar PSI score (Pearson X² test = 13.75, P = 0.185). The first group (24.4%) is composed of RFQs monotherapy. The second group (50.6%) is composed of RFQs plus β-lactams. The third group (25%) is composed of OUAT. Diabetes was the most common comorbidity among all (P = 0.847). There was no significant difference among the three groups in clinical improvement (P = 0.424) and speed of recovery (P = 0.398), however length of hospital stay was significantly shorter for the RFQs monotherapy (P = 0.004)

Cumulative curve for probability of discharge did not show significant difference among the three therapy groups (P ≥ 0.20)

Conclusion

There were no significant difference among the groups regarding end-of-treatment clinical improvement rates, speed of recovery and probability of hospital discharge. However, they significantly differ in length of hospital stay for RFQs monotherapy (P = 0.004).