Combined Antibiotic Lowers Death Rate Significantly in Critically Ill Patients with Pneumoccal Bacteremia

Combination antibiotic therapy improved survival significantly among critically ill patients who had severe pneumonia with complicating bactermia, according to published results from an international prospective, observational study.

The researchers studied 844 consecutive patients with bactermic pneumococcal pneumonia who were treated in 21 hospitals in 10 countries on six continents. (Bactermia is the presence of bacteria in the bloodstream, which is a relatively common problem. Usually, the bacteria are rapidly removed by white blood cells. However, sometimes there are too many bacteria to be removed easily and they overwhelm the white cells, resulting in a serious disease complication.)

Among the 844 adult patients with bactermia due to Streptococcus pneumoniae in the study, there were 94 who were critically ill. The combination antibiotic therapy received by 47 resulted in a 14-day mortality rate of 23.4 percent, as contrasted with the 55.3 percent mortality rate for the 47 on monotherapy.

The authors said that the improvement in survival was independent of the country of origin, intensive care unit support, class of antibiotics, or in vitro activity of the antibiotics prescribed.

Among the balance of patients who were not critically ill, the 14-day mortality rate was not significantly different between either the combination or monotherapy treatment groups. Overall, of the 844 patients, 16.5 percent (139) died by day 14 of their treatment. The study appears in the second issue for August 2004 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.