Objectives: Ceftriaxone is recommended as first-line antibiotic treatment (with the addition of macrolide) for hospitalised adults with community acquired pneumonia (CAP). Narrower-spectrum β-lactam as ampicillin, may be associated with comparable clinical outcomes, with less emergence of resistant pathogens or Clostridioides difficile infection (CDI). We aimed to examine whether ampicillin and ceftriaxone (with the addition of macrolides for both arms) are comparable for the treatment of hospitalized adults due to CAP.
Methods: This was a single center, observational cohort study. We included adult patients who were hospitalized in internal medicine wards due to CAP and were treated with either ceftriaxone or ampicillin with the addition of macrolide. A propensity-score model was used. The primary outcome was 30-day all-cause mortality. A multivariable logistic regression analysis and Kaplan-Meier survival analysis was performed. We performed subgroup analyses for the main outcome based on CURB-65 score and age.
Results: A total of 1586 patients fulfilled the inclusion criteria. There was no difference in 30-day mortality rate in the total cohort (28/233 vs. 208/1353 in ampicillin and ceftriaxone arm, respectively; p = 0.184). In the propensity matched cohort (197 in ampicillin and 394 in ceftriaxone arm), there was no significant difference in 30-day all-cause mortality between treatment groups in multivariable analysis of the main model (OR 0.67, 95% CI, 0.37-1.2; p = 0.189) and Kaplan-Meier survival analysis (p = 0.108). Thirty-day mortality rate was (19/197 vs. 57/394, in ampicillin and ceftriaxone arms, respectively; p = 0.108) Patients who were treated with ampicillin experienced significantly lower rates of CDI (0/197, 0% vs. 8/394, 2%; p = 0.044).
Discussion: Ampicillin was associated with comparable clinical outcomes in comparison to ceftriaxone for patients who were hospitalized due to CAP. Ampicillin was associated with significantly lower rate of CDI. Results need to be confirmed by more robust study designs.
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http://dx.doi.org/10.1016/j.cmi.2022.07.022 | DOI Listing |
IJID Reg
March 2025
Micobiology and Moclecular Biology Department, National Hospital for Tropical Diseases, Hanoi, Vietnam.
Objectives: This study describes the clinical and paraclinical features, antibiotic resistance levels, and treatment outcomes of septicemia acquired in the Vietnamese community.
Methods: A cross-sectional descriptive study was conducted on 102 patients with community-acquired sepsis caused by from July 2018 to July 2023.
Results: -induced community sepsis had a septic shock rate of 13.
BMC Infect Dis
January 2025
Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Background: Escherichia coli (E. coli) O157:H7, associated with diarrhea, poses a global health risk. In Ethiopia, where diarrhea is common, there is limited knowledge about these resistant strains and a lack of data on Extended-Spectrum β-Lactamase (ESBL) and carbapenemase production.
View Article and Find Full Text PDFBMC Infect Dis
January 2025
Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Background: Neonatal sepsis is a leading cause of death in low- and middle- income countries (LMIC). Increasing antibiotic resistance in early onset (< 72 h of life) bloodstream infection (EO-BSI) pathogens in LMIC has reduced the effectiveness of the recommended empiric antibiotic regimen (ampicillin plus gentamicin).
Methods: We retrospectively analysed blood culture-confirmed EO-BSI episodes at nine neonatal units from three central and six peripheral hospitals in the Western Cape Province, South Africa between 1 January 2017 and 31 December 2018.
J Infect Dev Ctries
December 2024
Department of Microbiology & Hygiene, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh.
Introduction: The emergence of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is a growing public health concern. The objective of this study was to determine the prevalence and multi-drug resistant (MDR) profiles of MRSA in goats in Bangladesh.
Methodology: A total of 150 samples from goats comprised of rectal swab (n = 50), nasal swab (n = 50), and milk (n = 50) were collected.
PLOS Glob Public Health
January 2025
Department of Global Health Security, Infectious Diseases Institute, Makerere University, Kampala, Uganda.
Infections with multi-drug-resistant (MDR) pathogens in food-animals threaten public health and food security. However, the epidemiology and factors associated with MDR Escherichia coli (MDR E. coli) on Ugandan farms are not well known.
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