Ertapenem therapy for pneumonia requiring hospital admission in elderly people.

Objective: Few studies examined ertapenem for the treatment of pneumonia. This study aims to compare ertapenem with other antibiotics commonly used for the treatment of pneumonia requiring hospital admission in elderly patients in daily clinical practice.

Methods: We conducted an observational, retrospective case-control study,between January 2011 and January 2014, in a university hospital. Patients ≥65 years of age admitted to the hospital with pneumonia treated with ertapenem were included as cases. A control patient treated with antibiotics other than ertapenem, matched for age and pneumonia severity index (PSI), was enrolled for each case. Hospital mortality was the primary outcome.

Results: A total of 150 patients with a mean age of 84.1 years were studied. Ninety percent of patients had pneumonia PSI grade IV-V and 82.7% had one or more comorbidities. Healthcare-associated pneumonia (HCAP) and aspiration pneumonia were significantly higher in the ertapenem group (66.7% vs. 24.0%, p < 0.001 and 73.3% vs. 54.7%, p < 0.017, respectively), whereas malignancy was most common in the control group. There was no difference in the hospital mortality rate between ertapenem and control groups (20.0% vs. 20.0%, p = 0.500), after adjusting for HCAP, aspiration pneumonia and malignancy. Transfer from hospital to hospital at home was significantly higher in the ertapenem group (25.3% vs. 9.3%, p = 0.09).

Conclusions: Ertapenem is as effective as other antibiotics commonly used for the treatment of pneumonia requiring hospital admission in elderly people. Ertapenem is associated with a higher transfer to hospital at home.