β-Lactam Monotherapy vs β-Lactam-Macrolide Combination Treatment in Moderately Severe Community-Acquired Pneumonia: A Randomized Noninferiority Trial.
Fiche du document
2014
- doi: 10.1001/jamainternmed.2014.4887
- issn: 2168-6106
Ce document est lié à :
info:eu-repo/semantics/altIdentifier/doi/10.1001/jamainternmed.2014.4887
Ce document est lié à :
info:eu-repo/semantics/altIdentifier/pmid/25286173
Ce document est lié à :
info:eu-repo/semantics/altIdentifier/eissn/2168-6114
Ce document est lié à :
info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_6377CAD0EAE65
info:eu-repo/semantics/openAccess , Copying allowed only for non-profit organizations , https://serval.unil.ch/disclaimer
Sujets proches
Upper limb Limb, Upper Upper extremities Extremity, Upper Pectoral limbs Limb, Pectoral Thoracic limbs Extremities, Upper Upper limbs Limb, Thoracic Arms (Anatomy) Thoracic limb Upper extremity Pectoral limbCiter ce document
N. Garin et al., « β-Lactam Monotherapy vs β-Lactam-Macrolide Combination Treatment in Moderately Severe Community-Acquired Pneumonia: A Randomized Noninferiority Trial. », Serveur académique Lausannois, ID : 10.1001/jamainternmed.2014.4887
Métriques
Partage / Export
Résumé
IMPORTANCE: The clinical benefit of adding a macrolide to a β-lactam for empirical treatment of moderately severe community-acquired pneumonia remains controversial. OBJECTIVE: To test noninferiority of a β-lactam alone compared with a β-lactam and macrolide combination in moderately severe community-acquired pneumonia. DESIGN, SETTING, AND PARTICIPANTS: Open-label, multicenter, noninferiority, randomized trial conducted from January 13, 2009, through January 31, 2013, in 580 immunocompetent adult patients hospitalized in 6 acute care hospitals in Switzerland for moderately severe community-acquired pneumonia. Follow-up extended to 90 days. Outcome assessors were masked to treatment allocation. INTERVENTIONS: Patients were treated with a β-lactam and a macrolide (combination arm) or with a β-lactam alone (monotherapy arm). Legionella pneumophila infection was systematically searched and treated by addition of a macrolide to the monotherapy arm. MAIN OUTCOMES AND MEASURES: Proportion of patients not reaching clinical stability (heart rate 90 mm Hg, temperature