All-cause community acquired pneumonia cost by age and risk in real-world conditions of care in Spain

2021 ◽  
Author(s):  
Javier Rejas ◽  
Antoni Sicras-Mainar ◽  
Aram Sicras-Navarro ◽  
Nadia Lwoff ◽  
Cristina Méndez
Keyword(s):  
Real World ◽  
Community Acquired Pneumonia

Ceftaroline for severe community-acquired pneumonia: A real-world two-centre experience in Italy and Spain

2020 ◽  
Vol 55 (4) ◽  
pp. 105921
Author(s):  
Matteo Bassetti ◽  
Alessandro Russo ◽  
Catia Cilloniz ◽  
Daniele Roberto Giacobbe ◽  
Antonio Vena ◽  
...  
Keyword(s):  
Real World ◽  
Community Acquired Pneumonia ◽  
Severe Community Acquired Pneumonia

scholarly journals Effectiveness and safety evaluation of oral cefixime and moxifloxacin fixed dose combination in lower respiratory tract infections

2019 ◽  
Vol 6 (6) ◽  
pp. 1808
Author(s):  
Manish Agrawal ◽  
Rajeev Adkar ◽  
Milind Kulkarni ◽  
Dhaval J. Sheth ◽  
Rommel Idnani ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Real World ◽  
Lower Respiratory Tract ◽  
Safety Evaluation ◽  
Community Acquired Pneumonia ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
End Of Treatment ◽  
Dose Combination ◽  
Tract Infections

Background: Scientific literature advocates the need for combination therapies in combatting lower respiratory tract infection (LRTI). Cefixime (400 mg) and moxifloxacin (400 mg) fixed dose combination (FDC) is currently approved in India for the management of LRTI, but data related to its real world usage is lacking. The present study was designed to understand the real world use (effectiveness and safety) of this FDC in LRTI.Methods: This retrospective study was conducted at out-patient departments of 5 hospitals between August 2018 and January 2019. After ethics committee approval, data of adults LRTI patients who received FDC of cefixime (400 mg) and moxifloxacin (400 mg) for at least 72 hours was collected. Improvement in LRTI symptoms (cough, sputum volume and purulence, fever, dyspnea, pleuritic chest pain, sleep disturbance, fatigue) were scored at baseline and follow-up using a 5-point severity scale. White blood cell (WBC) counts at baseline and end-of-treatment were compared.Results: Data of 190 patients having mean age 42.33+16.15 years was evaluated. Majority were males (61.58%), with commonest LRTI infection being community acquired pneumonia (CAP) (84.21%). Commonest clinical symptom reported (97.37%) was cough. All patients showed improvement in symptoms and significant improvement in all mean symptom scores were noted (p<0.05). Of the 30 patients having WBC above normal range, 29 showed a decrease in count at end of treatment. No adverse events were reported.Conclusions: Oral FDC of cefixime (400 mg) and moxifloxacin (400 mg) was efficacious in improving all symptoms reported by LRTI patients without causing any adverse event.

scholarly journals Relationship between Time to Clinical Response and Outcomes among Pneumonia Outcomes Research Team (PORT) Risk Class III and IV Hospitalized Patients with Community-Acquired Pneumonia Who Received Ceftriaxone and Azithromycin

2014 ◽  
Vol 58 (7) ◽  
pp. 3804-3813 ◽  
Author(s):  
Evan Zasowski ◽  
Jill M. Butterfield ◽  
Louise-Ann McNutt ◽  
Jason Cohen ◽  
Leon Cosler ◽  
...  
Keyword(s):  
Clinical Response ◽  
Real World ◽  
Outcomes Research ◽  
Research Team ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Class Iii ◽  
Risk Class ◽  
Fda Guidance ◽  
Cart Analysis

ABSTRACTRecent Food and Drug Administration (FDA) guidance endorses the use of an early clinical response endpoint as the primary outcome for community-acquired bacterial pneumonia (CABP) trials. While antibiotics will now be approved for CABP, in practice they will primarily be used to treat patients with community-acquired pneumonia (CAP). More importantly, it is unclear how achievement of the new FDA CABP early response endpoint translates into clinically applicable real-world outcomes for patients with CAP. To address this, a retrospective cohort study was conducted among adult patients who received ceftriaxone and azithromycin for CAP of Pneumonia Outcomes Research Team (PORT) risk class III and IV at an academic medical center. The clinical response was defined as clinical stability for 24 h with improvement in at least one pneumonia symptom and with no symptom worsening. A classification and regression tree (CART) was used to determine the delay in response time, measured in days, associated with the greatest risk of a prolonged hospital length of stay (LOS) and adverse outcomes (in-hospital mortality or 30-day CAP-related readmission). A total of 250 patients were included. On average, patients were discharged 2 days following the achievement of a clinical response. In the CART analysis, adverse clinical outcomes were higher among day 5 nonresponders than those who responded by day 5 (22.4% versus 6.9%,P= 0.001). The findings from this study indicate that time to clinical response, as defined by the recent FDA guidance, is a reasonable prognostic indictor of real-world effectiveness outcomes among hospitalized PORT risk class III and IV patients with CAP who received ceftriaxone and azithromycin.

scholarly journals Impact of Procalcitonin Guidance on the Management of Adults Hospitalized with Pneumonia

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S17-S17
Author(s):  
Thomas Walsh ◽  
Briana DiSilvio ◽  
Crystal Hammer ◽  
Moeezullah Beg ◽  
Swati Vishwanathan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Antibiotic Therapy ◽  
Real World ◽  
Antibiotic Use ◽  
Hospital Length ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Teaching Hospitals ◽  
Post Intervention ◽  
Duration Of Therapy

Abstract Background Community-acquired pneumonia and healthcare-associated pneumonia are often treated with prolonged antibiotic therapy. Procalcitonin (PCT) has effectively and safely reduced antibiotic use for pneumonia in controlled studies. However, limited data exist regarding PCT guidance in real-world settings for management of pneumonia. Methods A retrospective, preintervention/postintervention quality improvement study was conducted to compare management for patients admitted with pneumonia before and after implementation of PCT guidance at two teaching hospitals in Pittsburgh, Pennsylvania. The preintervention period was March 1, 2014 through October 31, 2014, and the post-intervention period was March, 1 2015 through October 31, 2015. Results A total of 152 and 232 patients were included in the preintervention and postintervention cohorts, respectively. When compared with the preintervention group, the mean duration of therapy decreased (9.9 vs. 6.1 days; P &lt; 0.001). More patients received an appropriate duration of 7 days or less (26.9% vs. 66.4%; P &lt; 0.001). Additionally, mean hospital length of stay decreased in the postintervention group (4.9 vs. 3.5 days; P = 0.006). Pneumonia-related 30-day readmission rates (7.2% vs. 4.3%; P = 0.99) were unaffected. In the postintervention group, patients with PCT levels &lt; 0.25 µg/l received shorter mean duration of therapy compared with patients with levels &gt;0.25 µg/l (8.0 vs. 4.6 days; P &lt; 0.001) as well as reduced hospital length of stay (3.9 vs. 3.2 days; P = 0.02). Conclusion In this real-world practice study, PCT guidance led to shorter durations of total antibiotic therapy and abridged inpatient length of stay without affecting hospital re-admissions. Disclosures All authors: No reported disclosures.

scholarly journals A Large Gap in Patients’ Characteristics and Outcomes between the Real-World and Clinical Trial Settings in Community-Acquired Pneumonia and Healthcare-Associated Pneumonia

2022 ◽  
Vol 11 (2) ◽  
pp. 297
Author(s):  
Nobuhiro Asai ◽  
Yuichi Shibata ◽  
Daisuke Sakanashi ◽  
Hideo Kato ◽  
Mao Hagihara ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Real World ◽  
Randomized Clinical Trials ◽  
Community Acquired Pneumonia ◽  
Rank Test ◽  
Exclusion Criteria ◽  
The Real ◽  
Log Rank Test ◽  
Healthcare Associated ◽  
Based Medicine

(1) Introduction: Evidence-based medicine (EBM) is necessary to standardize treatments for infections because EBM has been established based on the results of clinical trials. Since entry criteria for clinical trials are very strict, it may cause skepticism or questions on whether the results of clinical trials reflect the real world of medical practice. (2) Methods: To examine how many patients could join any randomized clinical trials for the treatment of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP). We reviewed all the pneumonia patients in our institute during 2014–2017. The patients were divided into two groups: patients who were eligible for clinical trials (participation-possible group), and those who were not (participation-impossible group). Exclusion criteria for clinical trials were set based on previous clinical trials. (3) Results: A total of 406 patients were enrolled in the present study. Fifty-seven (14%) patients were categorized into the participation-possible group, while 86% of patients belonged to the participation-impossible group. Patients in the participation-possible group had less comorbidities and more favorable outcomes than those with the participation-impossible group. As for the outcomes, there were significant differences in the 30-day and in-hospital mortality rates between the two groups. In addition, the participation-possible group showed a longer overall survival time than the participation-impossible group (p < 0.001 by Log-Rank test). (4) Conclusion: There is a difference in patients’ profile and outcomes between clinical trials and the real world. Though EBM is essential to advance medicine, we should acknowledge the facts and the limits of the clinical trials.

Replications can cause distorted belief in scientific progress

2018 ◽  
Vol 41 ◽  
Author(s):  
Michał Białek
Keyword(s):  
Real World ◽  
Scientific Progress ◽  
The Public ◽  
Psychological Science

AbstractIf we want psychological science to have a meaningful real-world impact, it has to be trusted by the public. Scientific progress is noisy; accordingly, replications sometimes fail even for true findings. We need to communicate the acceptability of uncertainty to the public and our peers, to prevent psychology from being perceived as having nothing to say about reality.

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