Comparative Outcome Analysis of Penicillin-Based Versus Fluoroquinolone-Based Antibiotic Therapy for Community-Acquired Pneumonia
Journal
Medicine (United States)
Journal Volume
95
Journal Issue
6
Pages
e2763
Date Issued
2016-02-01
Author(s)
Abstract
Community-Acquired pneumonia (CAP) is a common but potentially life-Threatening condition, but limited information exists on the effectiveness of fluoroquinolones compared to β-lactams in outpatient settings. We aimed to compare the effectiveness and outcomes of penicillins versus respiratory fluoroquinolones for CAP at outpatient clinics. This was a claim-based retrospective cohort study. Patients aged 20 years or older with at least 1 new pneumonia treatment episode were included, and the index penicillin or respiratory fluoroquinolone therapies for a pneumonia episode were at least 5 days in duration. The 2 groups were matched by propensity scores. Cox proportional hazard models were used to compare the rates of hospitalizations/emergence service visits and 30-day mortality. A logistic model was used to compare the likelihood of treatment failure between the 2 groups. After propensity score matching, 2622 matched pairs were included in the final model. The likelihood of treatment failure of fluoroquinolone-based therapy was lower than that of penicillin-based therapy (adjusted odds ratio [AOR], 0.88; 95% confidence interval [95%CI], 0.77-0.99), but no differences were found in hospitalization/emergence service (ES) visits (adjusted hazard ratio [HR], 1.27; 95% CI, 0.92-1.74) and 30-day mortality (adjusted HR, 0.69; 95% CI, 0.30-1.62) between the 2 groups. The likelihood of treatment failure of fluoroquinolone-based therapy was lower than that of penicillin-based therapy for CAP on an outpatient clinic basis. However, this effect may be marginal. Further investigation into the comparative effectiveness of these 2 treatment options is warranted. Copyright ? 2016 Wolters Kluwer Health, Inc. All rights reserved.
SDGs
Other Subjects
antiinfective agent; penicillin derivative; quinolone derivative; adult; aged; cohort analysis; Community-Acquired Infections; comparative study; female; human; male; middle aged; Pneumonia, Bacterial; retrospective study; Taiwan; treatment outcome; very elderly; young adult; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Cohort Studies; Community-Acquired Infections; Female; Fluoroquinolones; Humans; Male; Middle Aged; Penicillins; Pneumonia, Bacterial; Retrospective Studies; Taiwan; Treatment Outcome; Young Adult
Publisher
Lippincott Williams and Wilkins
Type
journal article