Respiratory Tract Infections In Patients Research Articles

Predictors of persistent respiratory infections in patients with primary antibody deficiency, data from the US Immunodeficiency network (USIDnet)

Predictors of persistent respiratory infections in patients with primary antibody deficiency, data from the US Immunodeficiency network (USIDnet)

Characterization and Antibiotic Sensitivity Profile of Bacteria Isolated from Patients with Respiratory Tract Infections in Bangladesh

The study was aimed to characterize bacterial isolates from respiratory tract infections (RTI) and investigate their antibiotic sensitivity profile. Selective media and biochemical tests were used to characterize 40 bacterial isolates. Antibiotic sensitivity testing was conducted using Kirby-Bauer disc diffusion method. About 42.5% (17) RTI patients were infected by Klebsiella pneumoniae, 30% (12) by Escherichia coli and 27.5% (11) by Pseudomonas aeruginosa with no significant gender variation (p-value <0.578). Overall, 47% (out of 20) antibiotics were sensitive, whereas 48% were resistant. Surprisingly, 18% P. aeruginosa and 20% K. pneumoniae were carbapenem-resistant and 4 out of 7 cephalosporin antibiotics were highly resistant irrespective of pathogens. E. coli showed better sensitivity to nitrofurantoin (78%) and levofloxacin (89%), while K. pneumoniae was insensitive to cotrimoxazole (88%), gentamycin (77%) and piperacillin/tazobactam (66%). On the other hand, P. aeruginosa did not respond to P. aeruginosa to nalidixic acid (60%) and ciprofloxacin (60%). This study concludes that nitrofurantoin, levofloxacin, cotrimoxazole, gentamycin and piperacillin/tazobactam antibiotics could be better alternative in treating bacterial RTIs.Dhaka Univ. J. Pharm. Sci. 16(2): 235-244, 2017 (December)

Epidemiology and diagnosis of the severe acute viral respiratory infections in patients admitted at IBN Sina University Hospital Rabat- Morocco

Epidemiology and diagnosis of the severe acute viral respiratory infections in patients admitted at IBN Sina University Hospital Rabat- Morocco

Effectiveness of an early switch from intravenous to oral antimicrobial therapy for lower respiratory tract infection in patients with severe motor intellectual disabilities.

An early switch from intravenous to oral antimicrobial therapy is useful for reducing the duration of the hospitalization in adult patients with community acquired-pneumonia, whereas the efficacy of switch therapy for pediatric patients with community acquired (CA)-lower respiratory tract infection (LRTI) is uncertain. The aim of this study is to investigate the efficacy of switch therapy for LRTI in patients with severe motor intellectual disabilities (SMID). This retrospective study was performed on 92 patients with SMID who were admitted to the Department of Pediatrics at the Hospital of University of Occupational and Environmental Health, Japan from April 1, 2010 to March 31, 2017 for the suspicion of bacterial LRTI and were initially treated with an intravenous antimicrobial agent. Clinical outcomes were compared between patients with switch therapy (Switch therapy group) and conventional intravenous antimicrobial therapy (No switch therapy group). Thirteen and 79 in patients with SMID belonged to Switch thrapy group and No switch therapy group, respectively. Length of hospital stay in Switch therapy group was significantly shorter than that in No switch therapy group (P=0.002). In the patients undergoing switch therapy, there was no patient who required re-treatment and/or re-hospitalization. Switch therapy for LRTI was useful for the reduction of length of hospital stay without increasing risk of re-treatment and re-hospitalization in patients with SMID.

SUN-LB307: Abdominal Ultrasound Findings of Gastrointestinal Motility are Effective in Predicting the Risk of Fever Due to Respiratory Infections in Patients with Feeding Tubes

SUN-LB307: Abdominal Ultrasound Findings of Gastrointestinal Motility are Effective in Predicting the Risk of Fever Due to Respiratory Infections in Patients with Feeding Tubes

Risks of smoking and benefits of smoking cessation on hospitalisations for cardiovascular events and respiratory infection in patients with rheumatoid arthritis: a retrospective cohort study using the Clinical Practice Research Datalink

ObjectivesTo investigate the associations between smoking status, smoking cessation and hospitalisations for cardiovascular events (CVE) and respiratory tract infections (RTI) in an inception cohort of patients with rheumatoid arthritis (RA).MethodsThe...

Neutrophil to Lymphocyte (N/L) and Platelet to Lymphocyte (P/L) Ratios in Differentiating Acute Heart Failure from Respiratory Infection.

The clinical manifestations of acute heart failure (AHF) and respiratory infection (RI) frequently overlap in patients presenting with dyspnoea at the emergency department (ED). The neutrophil to lymphocyte (N/L) and platelet to lymphocyte (P/L) ratios have been proposed as diagnostic and prognostic indices in this setting. To evaluate the ability of N/L and P/L ratios to discriminate the cause of dyspnoea in patients admitted with an initial diagnosis of AHF-RI. 100 consecutive dyspnoeic chronic heart failure (CHF) patients diagnosed as AHF-RI in the ED of Sotiria Chest Diseases General Hospital were monitored for a series of parameters. The diagnostic efficacy of the registered parameters in discriminating the AHF from RI patients was evaluated. The N/L and P/L ratios did not differ statistically depending on the pharmaceutical therapy applied in the study population, with the exception of furosemide and spironolactone-treated patients, who both had higher ratio values. In the AHF patients, only N/L was influenced by the pharmaceutical treatment administered. Patients with higher N/L ratio values were more likely to have RI-triggereddyspnoea (odds ratio, OR=1.35, 95% confidence interval-CI: 0.99-1.42, p=0.047). ROC curve (receiver operating characteristic curve) analysis revealed a significant ability of the N/L ratio to differentiate pure AHF from RI (area under the curve AUC=0.773, p<0.001, cut-off value N/L= 3.15). The N/L ratio, a cheap and easily assessed biomarker, warrants further investigation as a potential diagnostic tool for the ED physician facing dyspnoeic CHF patients.

Enteral nutrition volume is not correlated with lower respiratory tract infection in patients on mechanical ventilation

ObjectiveTo evaluate the effect of enteral nutrition volume, gastrointestinal function and the type of acid suppressive drug upon the incidence of lower respiratory tract infections in critically ill patients on mechanical ventilation (MV). DesignA retrospective secondary analysis was carried out. SettingThe Intensive Care Unit of a University Hospital. Patients or participantsPatients≥18-years-old expected to need MV for more than four days, and receiving enteral nutrition by nasogastric tube within 24h of starting MV. InterventionsWe correlated enteral nutrition volume administered during the first 10 days, gastrointestinal function and the type of acid suppressive therapy with the episodes of lower respiratory tract infection up until day 28. Cox proportional hazards ratios in univariate and adjusted multivariate models were used. Statistical significance was considered for p<0.05. Main variables of interestLower respiratory tract infection episodes. ResultsSixty-six out of 185 patients (35.7%) had infection; 27 patients had ventilator-associated pneumonia; and 39 presented ventilator-associated tracheobronchitis. Uninfected and infected groups were similar in terms of enteral nutrition volume (54±12 and 54±9mL/h; p=0.94) and caloric intake (19.4±4.9 and 19.6±5.2kcal/kg/d; p=0.81). The Cox proportional hazards model showed neurological indication of MV to be the only independent variable related to infection (p=0.001). Enteral nutrition volume, the type of acid suppressive therapy, and the use of prokinetic agents were not significantly correlated to infection. ConclusionsEnteral nutrition volume and caloric intake, gastrointestinal dysfunction and the type of acid suppressive therapy used were not associated to lower respiratory tract infection in patients on MV.

Antibiotic susceptibility pattern of bacteria isolated from patients of respiratory tract infection in a tertiary care hospital of Central India

Background: Respiratory tract infections are one of the commonest types of infections affecting the Indian population and are a significant cause of morbidity and mortality. To deal with multidrug resistance one should be armed with region specific data about the susceptibility patterns of antimicrobials. This study was planned to identify the common pathogens responsible for the respiratory tract infection and their antibiotic susceptibility patterns.Methods: Smears were prepared from the specimens and gram stains of all clinical samples were done. The organisms were grown on various media and identified according to the standard procedures. The susceptibility patterns of the bacterial pathogens were determined following the panel of antimicrobial agents. Descriptive statistics were used for data analysis.Results: Out of 513 samples 471 samples were further processed. Klebsiella (30.42%) was found to be commonest pathogen followed by Pseudomonas (28.36%). Ampicillin and piperacillin /tazobactam combination were found to be highly efficient against Pseudomonas (83% and 58.8% respectively), E. coli (68% and 50.7% respectively), and Klebsiella (43% and 30.3% respectively). Conclusions: In our study, we found penicillins as the most efficacious antimicrobials to treat respiratory pathogens. The study reveals that the antibiotic susceptibility pattern varies across regions. The prescription of a right antibiotic, for a right patient will help to minimize the menace of emergence of antimicrobial resistance.

Chronic Respiratory Infection in Patients with Chronic Obstructive Pulmonary Disease: What Is the Role of Antibiotics?

Chronic infections are associated with exacerbation in patients with chronic obstructive pulmonary disease (COPD). The major objective of the management of these patients is the prevention and effective treatment of exacerbations. Patients that have increased sputum production, associated with purulence and worsening shortness of breath, are the ones that will benefit from antibiotic therapy. It is important to give the appropriate antibiotic therapy to prevent treatment failure, relapse, and the emergence of resistant pathogens. In some patients, systemic corticosteroids are also indicated to improve symptoms. In order to identify which patients are more likely to benefit from these therapies, clinical guidelines recommend stratifying patients based on their risk factor associated with poor outcome or recurrence. It has been identified that patients with more severe disease, recurrent infection and presence of purulent sputum are the ones that will be more likely to benefit from this therapy. Another approach related to disease prevention could be the use of prophylactic antibiotics during steady state condition. Some studies have evaluated the continuous or the intermittent use of antibiotics in order to prevent exacerbations. Due to increased bacterial resistance to antibiotics and the presence of side effects, several antibiotics have been developed to be nebulized for both treatment and prevention of acute exacerbations. There is a need to design long-term studies to evaluate these interventions in the natural history of the disease. The purpose of this publication is to review our understanding of the role of bacterial infection in patients with COPD exacerbation, the role of antibiotics, and future interventions.

Evaluation of Anti-Infectives on Acute Respiratory Infection in Patients at Three Primary Health Cares Centres in Depok, Indonesia

Introduction: The high prevalence of Acute Respiratory Infection (ARI) in Indonesia can increase anti-infective use and affect their patterns of use. Objective: This study aimed to evaluate anti-infective use in 2015 at 3 primary health care centres, Limo Primary Health Care (LPHC), Bojongsari Primary Health Care (BPHC), and Cipayung Primary Health Care (CPHC). Material and methods: This study was descriptive analytic research using retrospective data. Samples consisted of 20,41 ARI patients’ prescriptions containing anti-infective drugs during 2015. Anti-infective drugs were classified using the anatomical therapeutic chemical (ATC) classification system. Drug use was measured as Daily Defined Dose (DDD)/1000 patients/day. Drug use 90% and adherence to the National Formulary was evaluated as an indicator of the quality of prescribing drugs. Results: The highest amount of anti-infective use for ARI patients was at CPHC with a total quantity of 0.95 DDD/1000 patient/day. While at the LPHC amount of anti-infective use was 0.76 DDD/1000 patients/day and at BPHC was only 0.65 DDD/1000 patients/day. The most anti-infectives use at all primary health cares was amoxicillin. Ten anti-infectives were use at LPHC, 11 at BPHC and 7 at CPHC. Anti-infectives in the DU 90% segment at LPHC were amoxicillin, co-trimoxazole, and cefadroxil while amoxicillin was the only DU90% anti-infective used at CPHC and BPHC. The adherence to National Formulary were 70.00% at LPHC, 71.43%, at BPHC, and 63.64% at CPHC. Conclusion: The use of anti-infective varied and it showed that some did not adhere to National Formulary guidelines. Key words: Adherence, Anti-infective, ATC/DDD, National Formulary, Primary health care

Prevalence of Moraxella catarrhalis in patients of lower respiratory tract infection with underlying risk factors

Background: Moraxella catarrhalis is a Gram-negative diplococcus, commonly found as a normal flora in the human upper respiratory tract. Recently, M. catarrhalis has emerged as an important and common human respiratory tract pathogen. This study was aimed to determine the rate of isolation of M. Catarrhalis in patients attending a tertiary care hospital with lower respiratory tract infection (LRTI), antibiotic susceptibility pattern and predisposing factors responsible for their infection.Methods: A prospective study was carried out in 1001 lower respiratory specimens from patients (above 20 years’ age) with suspected LRTI. The study investigated by microscopic examination, culture and antibiotic sensitivity test according to the standard guidelines. Assessment of clinical significance of M. Catarrhalis was ascertained on the basis of preformed criteria.Results: A total of 60 clinically significant M. Catarrhalis were isolated from the 930 culture positive samples. The isolates showed maximum sensitivity to second and third generation cephalosporins (95%), azithromycin (90%) followed by amoxicillin clavulanic acid (85%). Rate of isolation was more in males (70%) and elderly people above 60 years (63.33%) were found to be more affected. Patients (58.33%) with Chronic Obstructive Pulmonary Diseases (COPD) were found to be more prone to get infection by M. Catarrhalis.Conclusions: Moraxella catarrhalis should be considered as significant lower respiratory tract pathogen especially in elderly patients with underlying risk factors like COPD.

Enteral nutrition volume is not correlated with lower respiratory tract infection in patients on mechanical ventilation

ObjectiveTo evaluate the effect of enteral nutrition volume, gastrointestinal function and the type of acid suppressive drug upon the incidence of lower respiratory tract infections in critically ill patients on mechanical ventilation (MV). DesignA retrospective secondary analysis was carried out. SettingThe Intensive Care Unit of a University Hospital. Patients or participantsPatients≥18-years-old expected to need MV for more than four days, and receiving enteral nutrition by nasogastric tube within 24h of starting MV. InterventionsWe correlated enteral nutrition volume administered during the first 10 days, gastrointestinal function and the type of acid suppressive therapy with the episodes of lower respiratory tract infection up until day 28. Cox proportional hazards ratios in univariate and adjusted multivariate models were used. Statistical significance was considered for p<0.05. Main variables of interestLower respiratory tract infection episodes. ResultsSixty-six out of 185 patients (35.7%) had infection; 27 patients had ventilator-associated pneumonia; and 39 presented ventilator-associated tracheobronchitis. Uninfected and infected groups were similar in terms of enteral nutrition volume (54±12 and 54±9mL/h; p=0.94) and caloric intake (19.4±4.9 and 19.6±5.2kcal/kg/d; p=0.81). The Cox proportional hazards model showed neurological indication of MV to be the only independent variable related to infection (p=0.001). Enteral nutrition volume, the type of acid suppressive therapy, and the use of prokinetic agents were not significantly correlated to infection. ConclusionsEnteral nutrition volume and caloric intake, gastrointestinal dysfunction and the type of acid suppressive therapy used were not associated to lower respiratory tract infection in patients on MV.

The cumulative effects of intravenous antibiotic treatments on hearing in patients with cystic fibrosis

BackgroundAminoglycosides (AGs) and glycopeptides are antibiotics essential for treating life-threatening respiratory infections in patients with cystic fibrosis (CF). The goal of this study was to examine the effects of cumulative intravenous (IV)-AG (amikacin and/or tobramycin) and/or glycopeptide (vancomycin) dosing on hearing status in patients with CF. MethodsHearing thresholds were measured from 0.25 to 16.0kHz, in 81 participants with CF. Participants were categorized into two groups: normal hearing in both ears (≤25dB HL for all frequency bands) or hearing loss (>25dB HL for any frequency band in either ear). Participants were also characterized into quartiles by their cumulative IV-AG (with or without vancomycin) exposure. Dosing was calculated using two strategies: (i) total number of lifetime doses, and (ii) total number of lifetime doses while accounting for the total doses per day. This was referred to as the “weighted” method. ResultsParticipants in the hearing loss group were significantly older than those in the normal-hearing group. After adjusting for gender and age at the time of hearing test, participants in the two highest-quartile exposure groups were almost 5 X more likely to have permanent sensorineural hearing loss than those in the two lowest-quartile exposure groups. There was a small group of CF patients who had normal hearing despite high exposure to IV-antibiotics. ConclusionsCumulative IV-antibiotic dosing has a significant negative effect on hearing sensitivity in patients with CF, when controlling for age and gender effects. A trend for increasing odds of hearing loss was associated with increasing cumulative IV-antibiotic dosing.

Viral Respiratory Infections in Patients with Cancer

Context: Cancers are among the gravest causes of the intensive immunodeficiency and provide favorable conditions for severe respiratory tract infections. Evidence Acquisition: Using various keywords related to the subject matter, articles were analyzed in PubMed and appropriately selected for review. Results: In patients with cancer, some viral respiratory infections such as HRSV, Influenza virus, HCMV, HMPV and HPIV are prevalent. Conclusions: Viral respiratory infections in cancer patients are common and can worsen the patients’ condition and disrupt the treatment process. Therefore, prevention and treatment of respiratory viral infections in cancer patients is important.

Clinical evaluation of the isothermal amplification assays for the detection of four common respiratory viruses in children with pneumonia.

Respiratory viruses are recognized as serious causes of morbidity and mortality in lower respiratory tract infections in patients. Isothermal amplification assays are increasingly used in their detection because of their rapidity, simplicity and cost-effectiveness, when compared to traditional molecular diagnostic methods. However, systematic assessment of these assays in the clinical settings is rarely reported. MEDLINE (Pubmed) searches were done analysing subject headings and words in the abstract related to isothermal amplification assay and virus. Selected loop-mediated isothermal amplification assays (LAMP) for respiratory syncytial virus (RSV), human metapneumovirus (HMPV) and adenovirus (ADV) as well as a reverse transcription genome exponential amplification reaction assay (GEAR) for human rhinovirus (HRV) were clinically evaluated in a head to head comparison against a two-tube multiplex reverse transcription-PCR (RT-PCR) assay (two-tube assay) using 634 respiratory specimens from children with pneumonia from different regions in China. Discrepant results between isothermal amplification assays and the two-tube assay were resolved by sequencing. A comparison of sensitivities of each selected isothermal amplification assay among province, gender, and age groups was also analyzed. A total of 634 respiratory specimens selected from Hebei Province children's hospital and Hunan Provincial Center for Disease Control and Prevention were tested. The overall detection rate (number of positive specimens/total specimens) for viruses tested by Reverse transcription (RT)-LAMP/LAMP/RT-GEAR was 35.9% while the detection rate was 46.2% by the two-tube assay. The sensitivity of each isothermal amplification assay was 88.4%, 74.3%, 100% and 73.6% for RSV, HMPV, ADV and HRV, respectively. No false positives were found in isothermal amplification assays. All the discrepant negative results by isothermal amplification assays were confirmed false negatives by sequencing. The LAMP assay for ADV showed significant consistency with the two-tube assay. A higher sensitivity of RSV detection was found in Hunan Province than in Hebei Province (P=0.01). Among different age groups, a higher sensitivity of RSV detection was also found in children older than 1year, when compared to children less than 1year (P=0.01). The clinical performance of the selected isothermal amplification assays for different viruses varies. Multiple-center assessment is critical to evaluate isothermal amplification assays, especially for RNA viruses, for their broad use in clinical hospital. The selected LAMP assay for the detection of ADV is reliable and has great potential for use in clinics; however, the sensitivities of the LAMP/GEAR assays for the detection of RSV, HMPV and HRV need to be further improved to meet clinical requirements, although a statistical difference in sensitivity was only found for the selected LAMP assay for RSV.

Antimicrobial susceptibility patterns of clinical isolates of Pseudomonas aeruginosa isolated from patients of respiratory tract infections in a Tertiary Care Hospital, Peshawar.

Objective:This study aims to determine the prevalence and susceptibility pattern of Pseudomonas aeruginosa and multidrug-resistant (MDR) isolates in patients suffering from respiratory tract infection.Methods:A cross sectional study was conducted from January to December 2014 in Northwest General Hospital and Research Centre, Peshawar. A total of 615 sputum samples were collected from both in and out-patients. Sputum samples were collected as per standard procedure and were inoculated on Blood, MacConkey and Chocolate agar. The isolates were identified by standard protocols using biochemical tests. The antibiotic susceptibility pattern of each isolate was checked as per Clinical and Laboratory Standards Institute (CLSI) guidelines using Kirby-Bauer’s disc diffusion method.Results:Out of 615 sputum samples, 354 (57.56%) were culture positive. Out of these a total of 71 (20.05%) strains of Pseudomonas were isolated, where 54.93% was from males and 45.07% were from females (Mean age was 44.29 ± 22.72:). Highest sensitivity was seen to Amikacin (92.86%) followed by Meropenem (91.55%) while lowest sensitivity was seen to Cefoperazone + Sulbactam (16.9%). There were 39.44% MDR strains, out of which 25% were Extensively Drug Resistant (XDR) and 10.71% were Pan Drug Resistant (PDR). In vitro susceptibility of MDR isolates showed highest sensitivity to Amikacin (82.14%) followed by Carbapenems (78.57%). All MDR isolates were resistant to Cefoperazone + Sulbactam. Resistance to Piperacillin + Tazobactam was 96.43%.Conclusion:Pseudomonas aeruginosa is one of the commonly isolated organisms and it is becoming more resistant to commonly used antibiotics. Carbapenems and aminoglycosides were the two classes of drugs that showed highest activity against Pseudomonas aeruginosa.

Antibiotic Susceptibility Pattern of Bacterial Isolates from Patients of Respiratory Tract Infection at 43 Centers in Punjab, Pakistan

Respiratory tract infections are the most common diseases that are associated with social burden for the patient. In most cases, treatment is started before the culture sensitivity. Empiric therapy is based on symptoms and the medical practitioner’s experience. Antibiotic resistance has become a serious health problem in the world, and also in Pakistan. This study was conducted to ascertain the current scenario of bacterial susceptibility in respiratory tract infection in order to optimize empiric therapy among people of all groups of ages in Punjab province located in Pakistan. Forty three (43) centers were selected randomly in major cities of Punjab. The numbers of patients investigated in these centers were 311. The study was undertaken from January 2012 to December, 2012. This period spans all seasons in the study areas. Out of 311 bacterial isolates, Klebsiella species have been isolated in 41 cases (13.06%), Escherichia coli 74 (23.57%), Acinetobacter 43 (13.69%), β-hemolytic streptococcus 15 (4.78%), Pseudomonas species 111 (35.35%), Streptococcus pneumonia 10 (3.18%) and Staphylococcus aureus in 17 cases (5.41%). Gram-positive bacteria were isolated from 42 patients (13.51%) while Gram-negative bacteria were isolated from 269 patients (86.49%). On an average 30 antibiotics of various classes have been tested for the susceptibility of gram-positive bacteria and gram-negative bacteria. 66.25% of the antibiotics tested showed susceptibility to the gram-positive bacteria. Vancomycin showed maximum sensitivity (100%) to gram-positive bacteria followed by Linezolid (97.44%) and Fusidic acid (83.34%). On the other hand 33.44% of the antibiotics tested showed sensitivity to the gram-negative bacteria. Cefoperazone/Sulbactam showed maximum sensitivity (91.39%) to gram-negative bacteria followed by Imipenem (72.75%) and Pipercillin/Tazobactam (71.60%).

Human Washington University Polyomavirus in Patients with Respiratory Tract Infection in Kuwait

Objective: To determine Washington University (WU) polyomavirus strains circulating among hospitalized patients with respiratory tract infections (RTI) in Kuwait. Materials and Methods: Samples from 459 hospitalized children and adult RTI patients were screened for respiratory viruses by polymerase chain reaction from April 2013 to April 2016. The VP2 gene from WU virus (WUV)-positive samples was sequenced and subjected to phylogenetic analysis. Results: Of the 459 hospitalized RTI patients, 18 (3.9%) patients were positive for WUV infection. WUV infection was common among children aged ≤11 years (9 patients, 50%). Among the 18 WUV-infected hospitalized patients, viral co-infection was detected in 9 patients (50%). The most common viruses associated with mixed infection were respiratory syncytial virus and human rhinovirus (2 patients, 11.1% each). Of the 18 WUV-infected patients, 4 were sequenced and subjected to phylogenetic analysis. The circulating strains belong to type Ia and IIIb. Conclusion: This study enabled us to detect WUV among hospitalized RTI patients. Co-infection with other respiratory viruses was notable. Two circulating WUV genotypes (Ia and IIIb) were identified among hospitalized RTI patients in Kuwait.

Characteristics and Outcomes of Patients with Pneumocystis jirovecii Pneumonia Who Were Initiated on Antiretroviral Therapy While Hospitalized: A Preliminary Study

Background Pneumocystis jirovecii pneumonia (PJP) is the most frequent and severe respiratory infection in patients with acquired immunodeficiency syndrome (AIDS) with associated 20% mortality. There have been conflicting data regarding the optimal time to initiate antiretroviral therapy (ART) in these patients with most data suggesting benefit for early initiation. The objectives of this study were to compare patients with PJP and AIDS who were initiated on ART while hospitalized compared with those who were not; and to evaluate the association between inpatient initiation of ART and survival.Methods We conducted a retrospective chart review of patients 18 years or older with PJP and AIDS who were not on ART prior to admission. We collected demographic, laboratory and clinical information. SPSS was used to compare the two groups: those who initiated ART while inpatient (ART) vs.. those who did not (NoART)ResultsOf the 64 patients included in this study, 25 [39%] were in the ART group, 19 [27%] required intensive care unit (ICU), and 16 [25%] required mechanical ventilation (MV). There were no differences in age, gender, race/ethnicity, and smoking between the ART and NoART groups. A higher percentage of patients in the ART group received corticosteroids (96% vs. 72%; P = 0.020), required MV (48% vs.10%; P = 0.001), and ICU admission (60% vs. 10%; P = 0.000) than in the NoART group respectively. There were no differences in the ART and NoART groups in regards to ICU stay (4 vs. 0.5 days; P = 1.000) and APACHE II scores (15.2 vs. 10.7; P = 0.17). A total of 9 (14%) patients died while in the hospital 6 (24%) in ART vs.. 3 (8%) in NoART (P = 0.137).Conclusion Patients with PJP pneumonia who were initiated on ART while inpatient were more likely to require ICU admission, corticosteroids, and mechanical ventilation. There were no differences in APACHE II scores, CD4 count and mortality between those who initiated ART while inpatients vs. those who did not. Further studies with larger sample size are needed to evaluate the association between inpatient initiation of ART and survival.Disclosures All authors: No reported disclosures.