Prior antibiotics and outcomes in patients hospitalized with pneumonia

Abstract

Background: Prior studies of antibiotics prior to hospitalization for pneumonia have had divergent findings. Our purpose was to examine the association between classes of prior antibiotics and outcomes for those hospitalized with pneumonia. Methods: We included patients > 65 years admitted to US Veterans Affairs hospitals between 2002-2012 with pneumonia. Using multilevel regression models we examined prior antibiotic use within 90 days on 30-day mortality, ICU admission, mechanical ventilation, and vasopressors. Antibiotics were grouped as aminoglycosides, outpatient community-acquired pneumonia (CAP) antibiotics, other beta-lactams, and other antibiotics. Results: Cohort consisted of 94,910 patients and 29.8% received a prior antibiotic. Prior CAP antibiotics was associated with lower risk of non-mortality outcomes. Receipt of other beta-lactam antibiotics or other antibiotics were associated with increased mortality and other outcomes. View this table: Association of Prior Antibiotics with Outcomes Conclusions: Prior CAP antibiotics was not associated with worse outcomes, but beta-lactams or other antibiotics were associated with worse outcomes. Those being treated for outpatient pneumonia should be treated with antibiotics recommend by CAP clinical practice guidelines.