Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan
<b>Background/Objectives</b>: Although chronic infection by <i>Pseudomonas aeruginosa</i> among patients with bronchiectasis is associated with poor prognosis, the impact of antibiotics with <i>P. aeruginosa</i> coverage in patients with bronchiectasis who experie...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-12-01
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| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/13/12/1182 |
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| Summary: | <b>Background/Objectives</b>: Although chronic infection by <i>Pseudomonas aeruginosa</i> among patients with bronchiectasis is associated with poor prognosis, the impact of antibiotics with <i>P. aeruginosa</i> coverage in patients with bronchiectasis who experienced bacterial pneumonia or exacerbation of bronchiectasis has not been fully investigated. <b>Methods</b>: This study targeted patients with bronchiectasis who were admitted to hospitals because of bacterial pneumonia or exacerbation of bronchiectasis between April 2018 and March 2020 using a national inpatient database in Japan. The association of antipseudomonal antibiotic treatment with in-hospital mortality was assessed after propensity score matching to adjust the patients’ backgrounds. <b>Results</b>: In total, 4943 patients with bacterial pneumonia and 1914 patients with exacerbation of bronchiectasis were included in this study. The in-hospital mortality rate did not differ between patients who did and did not receive antipseudomonal agents among patients with bacterial pneumonia (9.0% [185/2045] vs. 7.4% [151/2045]; <i>p</i> = 0.053) and those with exacerbation of bronchiectasis (5.2% [42/803] vs. 4.1% [33/803] group; <i>p</i> = 0.287). <b>Conclusions</b>: The use of antibiotics covering <i>P. aeruginosa</i> does not apparently improve prognosis in patients with bacterial pneumonia or exacerbation of bronchiectasis. A prospective study focusing on the impact of antibiotics covering <i>P. aeruginosa</i> among patients with bronchiectasis in whom <i>P. aeruginosa</i> is isolated is required. |
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| ISSN: | 2079-6382 |