Macrolides reduce mortality in hospitalized bacteremic pneumococcal pneumonia patients

Israel: Researchers from Israel found that empirical therapy with Macrolides like Azithromycin and Roxithromycin has lessened the mortality by 45% in hospitalized bacteremic pneumococcal pneumonia (BPP) without even the necessity for a full course of therapy. The study results were published in the journal Clinical Infectious Diseases. 

Community-acquired pneumonia frequently causes hospitalization and death. Empirical therapy guidelines recommend the use of either combination therapy with a β-lactam and an advanced macrolide (azithromycin or clarithromycin) or mono-therapy with respiratory quinolones in hospitalized community-acquired pneumonia patients. As previous literature suggested lower mortality with advanced macrolides, Michal Chowers and the team from Israel conducted a study to characterize antibiotic treatment patterns and assess the role of quinolones or macrolides in empirical therapy. 

As a part of an ongoing, nationwide, prospective, population-based, active surveillance of pneumococcal bacteremia adult cases data was collected from all 26 hospitals and 1 major outpatient health maintenance organization from 1 July 2009 to 30 June 2017 in Israel. Cases without information on antibiotic treatment were excluded. A BPP case was defined by the isolation of Streptococcus pneumoniae from blood, with infiltrates on imaging. The independent predictors of in-hospital mortality were assessed by logistic regression analysis.