Findings from a U.S. claims-based retrospective study published in Hospital Practice call for the development of more effective antimicrobial treatments that have a reduced adverse events burden for patients with community-acquired pneumonia (CAP)

Currently available treatment options for CAP often carry the potential for treatment failure and safety risk. Researchers aimed to evaluate real-world outcome associated with currently available antimicrobial options in both inpatient (non-intensive care unit [ICU]) and outpatient settings.

The study included adults diagnosed with CAP treated with any oral fluoroquinolone, macrolide, or beta-lactam monotherapy in the outpatient setting, and intravenous (IV) levofloxacin or IV azithromycin/ceftriaxone in the inpatient setting. A total of 441,820 outpatients and 33,287 inpatients treated for CAP between 2007–2012 were included in the analysis. 

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Study authors found that in the outpatient setting, fluoroquinolone therapy resulted in a higher rate of documented adverse events (adjusted odds ratio [OR] 1.23, 95% CI: 1.20–1.25; P<0.0001) but a lower rate of retreatment (adjusted OR 0.9, 95% CI: 0.87–0.94; P<0.0001) compared with macrolides. For these patients, adverse events and retreatment were tied to higher costs. 

Patients treated with IV macrolide/beta-lactam combination vs. IV fluoroquinolone in the inpatient setting experienced a significantly longer length of stay in the hospital (4.71 vs. 4.38; P<0.0001) and higher overall costs ($3,535 more per stay; P<0.0001). 

Researchers concluded that new effective treatment options with a decreased adverse event profile for patients with CAP are needed in both the inpatient and outpatient settings. 

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