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Ceftriaxone versus ceftriaxone plus a macrolide for community-acquired pneumonia in hospitalized patients with HIV/AIDS: a randomized controlled trial
Mello, Claudia Figueiredo; Naucler, P; Della Negra, Marinella; Levin, A. S.
Afiliação
  • Mello, Claudia Figueiredo; Secretaria de Estado da Saúde. São Paulo. Instituto de Infectologia Emílio Ribas. São Paulo. BR
  • Naucler, P; Karolinska University Hospital. Stockholm. SE
  • Della Negra, Marinella; Secretaria de Estado da Saúde. São Paulo. Instituto de Infectologia Emílio Ribas. São Paulo. BR
  • Levin, A. S; Universidade de São Paulo. Faculdade de Medicina. São Paulo. BR
Clin. microbiol. infect ; 24(2): 146-151, Feb. 2018. ilus, tab
Article em En | SES-SP, SESSP-IIERPROD, SES-SP | ID: biblio-1022522
Biblioteca responsável: BR31.1
Localização: BR31.1; 2018_P-010
ABSTRACT

OBJECTIVES:

To evaluate if treatment with ceftriaxone and a macrolide, improved patient outcome when compared with monotherapy with ceftriaxone, in hospitalized patients with human immunodeficiency virus/acquired immunodeficient syndrome (HIV/AIDS) with community-acquired pneumonia (CAP).

METHODS:

Adult patients with HIV hospitalized due to suspected CAP were randomized to receive one of two regimens, ceftriaxone plus macrolide or ceftriaxone plus placebo, at a 11 proportion (Brazilian Clinical Trials Registry RBR-8wtq2b). The primary outcome was in-hospital mortality and the secondary outcomes were mortality within 14 days, need for vasoactive drugs, need for mechanical ventilation, time to clinical stability and length of hospitalization.

RESULTS:

A total of 227 patients were randomized, two were excluded after randomization; 225 patients were analysed (112 receiving ceftriaxone plus placebo and 113 receiving ceftriaxone plus macrolide). The frequency of the primary outcome, in-hospital mortality, was not statistically different between the regimens 12/112 (11%) patients who received ceftriaxone plus placebo and 17/113 (15%) who received ceftriaxone plus macrolide died during hospitalization (hazard ratio 1.22, 95% CI 0.57-2.59). We did not find differences between the regimens for any of the secondary outcomes, including mortality within 14 days, which occurred in 5/112 (4%) patients with ceftriaxone plus placebo and in 12/113 (11%) patients with ceftriaxone plus macrolide (relative risk 2.38, 95% CI 0.87-6.53)

CONCLUSIONS:

Among hospitalized patients with HIV/AIDS with CAP, treatment with ceftriaxone and a macrolide did not improve patient outcomes, when compared with ceftriaxone monotherapy
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Texto completo: 1 Coleções: 06-national / BR Base de dados: SES-SP / SESSP-IIERPROD Assunto principal: Pneumonia / Ceftriaxona / Infecções por HIV / Síndrome da Imunodeficiência Adquirida / Macrolídeos Tipo de estudo: Clinical_trials / Etiology_studies Limite: Humans Idioma: En Revista: Clin. microbiol. infect Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 06-national / BR Base de dados: SES-SP / SESSP-IIERPROD Assunto principal: Pneumonia / Ceftriaxona / Infecções por HIV / Síndrome da Imunodeficiência Adquirida / Macrolídeos Tipo de estudo: Clinical_trials / Etiology_studies Limite: Humans Idioma: En Revista: Clin. microbiol. infect Ano de publicação: 2018 Tipo de documento: Article