Community-acquired Legionella Pneumonia in the intensive care unit: Impact on survival of combined antibiotic therapy

J. Rello; S. Gattarello; J. Souto; J. Sole-Violan; J. Valles; R. Peredo; R. Zaragoza; L. Vidaur; A. Parra; J. Roig; J. Almirall; R. Alonso; B. Alvarez; F. Alvarez Lerma; J. R. Badia; F. Barcenilla; M. Bassetti; J. Blanquer; M. A. Blasco; F. Bobillo; M. Bodi; M. Borges; E. Bouza; M. J. Broch; N. Carrasco; M. Catalan; V. de la Torre; E. Diaz; A. Doblas; J. Fierro; F. Garcia; J. Garnacho; M. A. Herranz; M. J. Huertos; J. Jimenez; R. Jorda; D. Koulentis; D. Lopez; M. J. Lopez Cambra; M. J. Lopez Pueyo; A. Lores; F. Lucena; P. Luque; R. Maiez; E. Maravi; A. Margarit; A. Martin; G. Masdeu; A. Mendia; E. Mesalles; J. Pereira; G. Poulakou; J. Rello; F. Renedo; J. M. Ricard; J. C. Robles; L. Rocha; R. Sierra; J. M. Sirvent; J. Sole; B. Suberviola; A. Torres; J. Valles; L. Vidaur; R. Zaragoza

doi:10.1016/j.medin.2012.05.010

Community-acquired Legionella Pneumonia in the intensive care unit: Impact on survival of combined antibiotic therapy

J. Rello, S. Gattarello, J. Souto, J. Sole-Violan, J. Valles, R. Peredo, R. Zaragoza, L. Vidaur, A. Parra, J. Roig, J. Almirall, R. Alonso, B. Alvarez, F. Alvarez Lerma, J. R. Badia, F. Barcenilla, M. Bassetti, J. Blanquer, M. A. Blasco, F. BobilloM. Bodi, M. Borges, E. Bouza, M. J. Broch, N. Carrasco, M. Catalan, V. de la Torre, E. Diaz, A. Doblas, J. Fierro, F. Garcia, J. Garnacho, M. A. Herranz, M. J. Huertos, J. Jimenez, R. Jorda, D. Koulentis, D. Lopez, M. J. Lopez Cambra, M. J. Lopez Pueyo, A. Lores, F. Lucena, P. Luque, R. Maiez, E. Maravi, A. Margarit, A. Martin, G. Masdeu, A. Mendia, E. Mesalles, J. Pereira, G. Poulakou, J. Rello, F. Renedo, J. M. Ricard, J. C. Robles, L. Rocha, R. Sierra, J. M. Sirvent, J. Sole, B. Suberviola, A. Torres, J. Valles, L. Vidaur, R. Zaragoza

Department of Medicine

Research output: Contribution to journal › Article › Research › peer-review

24 Citations (Scopus)

Abstract

Objectives: To compare intensive care unit (ICU) mortality in patients with severe community-acquired pneumonia (SCAP) caused by Legionella pneumophila receiving combined therapy or monotherapy. Methods: A prospective multicenter study was made, including all patients with sporadic, community-acquired Legionnaires' disease (LD) admitted to the ICU. Admission data and information on the course of the disease were recorded. Antibiotic prescriptions were left to the discretion of the attending physician and were not standardized. Results: Twenty-five cases of SCAP due to L. pneumophila were included, and 7 patients (28%) out of 25 died after a median of 7 days of mechanical ventilation. Fifteen patients (60%) presented shock. Levofloxacin and clarithromycin were the antibiotics most commonly used in monotherapy, while the most frequent combination was rifampicin plus clarithromycin. Patients subjected to combination therapy presented a lower mortality rate versus patients subjected to monotherapy (odds ratio for death [OR] 0.15; 95%CI 0.02-1.04; p=. 0.08). In patients with shock, this association was stronger and proved statistically significant (OR for death 0.06; 95%CI 0.004-0.86; p=. 0.04). Conclusions: Combined antibiotic therapy decreases mortality in patients with SCAP and shock caused by L. pneumophila. © 2012 Elsevier España, S.L. and SEMICYUC.

Original language	English
Pages (from-to)	320-326
Journal	Medicina Intensiva
Volume	37
Issue number	5
DOIs	https://doi.org/10.1016/j.medin.2012.05.010
Publication status	Published - 1 Jun 2013

Keywords

Combined antibiotic therapy
Legionella pneumophila
Legionnaires' disease
Severe community-acquired pneumonia

Access to Document

10.1016/j.medin.2012.05.010

Cite this

Rello, J., Gattarello, S., Souto, J., Sole-Violan, J., Valles, J., Peredo, R., Zaragoza, R., Vidaur, L., Parra, A., Roig, J., Almirall, J., Alonso, R., Alvarez, B., Alvarez Lerma, F., Badia, J. R., Barcenilla, F., Bassetti, M., Blanquer, J., Blasco, M. A., ... Zaragoza, R. (2013). Community-acquired Legionella Pneumonia in the intensive care unit: Impact on survival of combined antibiotic therapy. Medicina Intensiva, 37(5), 320-326. https://doi.org/10.1016/j.medin.2012.05.010

@article{3590a8a7d3bd484aac73a0d5c4bf0d05,

title = "Community-acquired Legionella Pneumonia in the intensive care unit: Impact on survival of combined antibiotic therapy",

abstract = "Objectives: To compare intensive care unit (ICU) mortality in patients with severe community-acquired pneumonia (SCAP) caused by Legionella pneumophila receiving combined therapy or monotherapy. Methods: A prospective multicenter study was made, including all patients with sporadic, community-acquired Legionnaires' disease (LD) admitted to the ICU. Admission data and information on the course of the disease were recorded. Antibiotic prescriptions were left to the discretion of the attending physician and were not standardized. Results: Twenty-five cases of SCAP due to L. pneumophila were included, and 7 patients (28%) out of 25 died after a median of 7 days of mechanical ventilation. Fifteen patients (60%) presented shock. Levofloxacin and clarithromycin were the antibiotics most commonly used in monotherapy, while the most frequent combination was rifampicin plus clarithromycin. Patients subjected to combination therapy presented a lower mortality rate versus patients subjected to monotherapy (odds ratio for death [OR] 0.15; 95%CI 0.02-1.04; p=. 0.08). In patients with shock, this association was stronger and proved statistically significant (OR for death 0.06; 95%CI 0.004-0.86; p=. 0.04). Conclusions: Combined antibiotic therapy decreases mortality in patients with SCAP and shock caused by L. pneumophila. {\textcopyright} 2012 Elsevier Espa{\~n}a, S.L. and SEMICYUC.",

keywords = "Combined antibiotic therapy, Legionella pneumophila, Legionnaires' disease, Severe community-acquired pneumonia",

author = "J. Rello and S. Gattarello and J. Souto and J. Sole-Violan and J. Valles and R. Peredo and R. Zaragoza and L. Vidaur and A. Parra and J. Roig and J. Almirall and R. Alonso and B. Alvarez and {Alvarez Lerma}, F. and Badia, {J. R.} and F. Barcenilla and M. Bassetti and J. Blanquer and Blasco, {M. A.} and F. Bobillo and M. Bodi and M. Borges and E. Bouza and Broch, {M. J.} and N. Carrasco and M. Catalan and {de la Torre}, V. and E. Diaz and A. Doblas and J. Fierro and F. Garcia and J. Garnacho and Herranz, {M. A.} and Huertos, {M. J.} and J. Jimenez and R. Jorda and D. Koulentis and D. Lopez and {Lopez Cambra}, {M. J.} and {Lopez Pueyo}, {M. J.} and A. Lores and F. Lucena and P. Luque and R. Maiez and E. Maravi and A. Margarit and A. Martin and G. Masdeu and A. Mendia and E. Mesalles and J. Pereira and G. Poulakou and J. Rello and F. Renedo and Ricard, {J. M.} and Robles, {J. C.} and L. Rocha and R. Sierra and Sirvent, {J. M.} and J. Sole and B. Suberviola and A. Torres and J. Valles and L. Vidaur and R. Zaragoza",

year = "2013",

month = jun,

day = "1",

doi = "10.1016/j.medin.2012.05.010",

language = "English",

volume = "37",

pages = "320--326",

journal = "Medicina Intensiva",

issn = "0210-5691",

publisher = "Ediciones Doyma, S.L.",

number = "5",

}

Rello, J, Gattarello, S, Souto, J, Sole-Violan, J, Valles, J, Peredo, R, Zaragoza, R, Vidaur, L, Parra, A, Roig, J, Almirall, J, Alonso, R, Alvarez, B, Alvarez Lerma, F, Badia, JR, Barcenilla, F, Bassetti, M, Blanquer, J, Blasco, MA, Bobillo, F, Bodi, M, Borges, M, Bouza, E, Broch, MJ, Carrasco, N, Catalan, M, de la Torre, V, Diaz, E, Doblas, A, Fierro, J, Garcia, F, Garnacho, J, Herranz, MA, Huertos, MJ, Jimenez, J, Jorda, R, Koulentis, D, Lopez, D, Lopez Cambra, MJ, Lopez Pueyo, MJ, Lores, A, Lucena, F, Luque, P, Maiez, R, Maravi, E, Margarit, A, Martin, A, Masdeu, G, Mendia, A, Mesalles, E, Pereira, J, Poulakou, G, Rello, J, Renedo, F, Ricard, JM, Robles, JC, Rocha, L, Sierra, R, Sirvent, JM, Sole, J, Suberviola, B, Torres, A, Valles, J, Vidaur, L & Zaragoza, R 2013, 'Community-acquired Legionella Pneumonia in the intensive care unit: Impact on survival of combined antibiotic therapy', Medicina Intensiva, vol. 37, no. 5, pp. 320-326. https://doi.org/10.1016/j.medin.2012.05.010

TY - JOUR

T1 - Community-acquired Legionella Pneumonia in the intensive care unit: Impact on survival of combined antibiotic therapy

AU - Rello, J.

AU - Gattarello, S.

AU - Souto, J.

AU - Sole-Violan, J.

AU - Valles, J.

AU - Peredo, R.

AU - Zaragoza, R.

AU - Vidaur, L.

AU - Parra, A.

AU - Roig, J.

AU - Almirall, J.

AU - Alonso, R.

AU - Alvarez, B.

AU - Alvarez Lerma, F.

AU - Badia, J. R.

AU - Barcenilla, F.

AU - Bassetti, M.

AU - Blanquer, J.

AU - Blasco, M. A.

AU - Bobillo, F.

AU - Bodi, M.

AU - Borges, M.

AU - Bouza, E.

AU - Broch, M. J.

AU - Carrasco, N.

AU - Catalan, M.

AU - de la Torre, V.

AU - Diaz, E.

AU - Doblas, A.

AU - Fierro, J.

AU - Garcia, F.

AU - Garnacho, J.

AU - Herranz, M. A.

AU - Huertos, M. J.

AU - Jimenez, J.

AU - Jorda, R.

AU - Koulentis, D.

AU - Lopez, D.

AU - Lopez Cambra, M. J.

AU - Lopez Pueyo, M. J.

AU - Lores, A.

AU - Lucena, F.

AU - Luque, P.

AU - Maiez, R.

AU - Maravi, E.

AU - Margarit, A.

AU - Martin, A.

AU - Masdeu, G.

AU - Mendia, A.

AU - Mesalles, E.

AU - Pereira, J.

AU - Poulakou, G.

AU - Rello, J.

AU - Renedo, F.

AU - Ricard, J. M.

AU - Robles, J. C.

AU - Rocha, L.

AU - Sierra, R.

AU - Sirvent, J. M.

AU - Sole, J.

AU - Suberviola, B.

AU - Torres, A.

AU - Valles, J.

AU - Vidaur, L.

AU - Zaragoza, R.

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Objectives: To compare intensive care unit (ICU) mortality in patients with severe community-acquired pneumonia (SCAP) caused by Legionella pneumophila receiving combined therapy or monotherapy. Methods: A prospective multicenter study was made, including all patients with sporadic, community-acquired Legionnaires' disease (LD) admitted to the ICU. Admission data and information on the course of the disease were recorded. Antibiotic prescriptions were left to the discretion of the attending physician and were not standardized. Results: Twenty-five cases of SCAP due to L. pneumophila were included, and 7 patients (28%) out of 25 died after a median of 7 days of mechanical ventilation. Fifteen patients (60%) presented shock. Levofloxacin and clarithromycin were the antibiotics most commonly used in monotherapy, while the most frequent combination was rifampicin plus clarithromycin. Patients subjected to combination therapy presented a lower mortality rate versus patients subjected to monotherapy (odds ratio for death [OR] 0.15; 95%CI 0.02-1.04; p=. 0.08). In patients with shock, this association was stronger and proved statistically significant (OR for death 0.06; 95%CI 0.004-0.86; p=. 0.04). Conclusions: Combined antibiotic therapy decreases mortality in patients with SCAP and shock caused by L. pneumophila. © 2012 Elsevier España, S.L. and SEMICYUC.

AB - Objectives: To compare intensive care unit (ICU) mortality in patients with severe community-acquired pneumonia (SCAP) caused by Legionella pneumophila receiving combined therapy or monotherapy. Methods: A prospective multicenter study was made, including all patients with sporadic, community-acquired Legionnaires' disease (LD) admitted to the ICU. Admission data and information on the course of the disease were recorded. Antibiotic prescriptions were left to the discretion of the attending physician and were not standardized. Results: Twenty-five cases of SCAP due to L. pneumophila were included, and 7 patients (28%) out of 25 died after a median of 7 days of mechanical ventilation. Fifteen patients (60%) presented shock. Levofloxacin and clarithromycin were the antibiotics most commonly used in monotherapy, while the most frequent combination was rifampicin plus clarithromycin. Patients subjected to combination therapy presented a lower mortality rate versus patients subjected to monotherapy (odds ratio for death [OR] 0.15; 95%CI 0.02-1.04; p=. 0.08). In patients with shock, this association was stronger and proved statistically significant (OR for death 0.06; 95%CI 0.004-0.86; p=. 0.04). Conclusions: Combined antibiotic therapy decreases mortality in patients with SCAP and shock caused by L. pneumophila. © 2012 Elsevier España, S.L. and SEMICYUC.

KW - Combined antibiotic therapy

KW - Legionella pneumophila

KW - Legionnaires' disease

KW - Severe community-acquired pneumonia

U2 - 10.1016/j.medin.2012.05.010

DO - 10.1016/j.medin.2012.05.010

M3 - Article

SN - 0210-5691

VL - 37

SP - 320

EP - 326

JO - Medicina Intensiva

JF - Medicina Intensiva

IS - 5

ER -

Community-acquired Legionella Pneumonia in the intensive care unit: Impact on survival of combined antibiotic therapy

Abstract

Keywords

Access to Document

Fingerprint

Cite this