Clinical Benefits of Piperacillin/Tazobactam versus a Combination of Ceftriaxone and Clindamycin in the Treatment of Early, Non-Ventilator, Hospital-Acquired Pneumonia in a Community-Based Hospital

Figures & data

Table 1 Demographics and Clinical Outcomes of Patients with Early, Non-Ventilator Hospital-Acquired Pneumonia in the Ceftriaxone Plus Clindamycin Group Vs Piperacillin/Tazobactam Group

Variables	Ceftriaxone Clindamycin (n=89)	Piperacillin Tazobactam (n=124)	P value
Sex, male	56 (62.9)	61 (65.3)	0.718
Age (years)	70.67 (54.25–80.63)	64.43 (54.33–74.43)	0.093
Patients with any comorbidity
Diabetes mellitus	19 (21.3)	31 (25)	0.535
Cardiovascular disease	42 (47.2)	73 (58.9)	0.092
Liver disease	14 (15.7)	16 (12.9)	0.559
Renal disease	4 (4.5)	9 (7.2)	0.406
Neurologic disease	49 (55.1)	40 (32.3)	<0.001
Solid cancer (except lung cancer)	2 (2.2)	26 (21)	<0.001
Connective tissue disease	0 (0)	10 (8.1)	0.006
CWI score	1 (0–1)	2 (1–2)	0.002
Severity variables at admission
PSI score≥91 (high risk)	42 (47.2)	53 (42.7)	0.519
PSI score	89 (71.5–104)	86.5 (71–104)	0.651
ICU stays	62 (69.7)	62 (50)	0.004
WBC, x 10^3uL	9.71 (7.43–12.535)	10.09 (7.95–12.625)	0.954
CRP, mg/dl	5.69 (2.37–10.14)	11.49 (6.24–17.04)	<0.001
Clinical outcomes
Clinical failure	26 (29.2)	10 (8.1)	<0.001
30 days mortality	4 (4.5)	2 (1.6)	0.202
Any side effects of antibiotics	2 (2.1)	0 (0)	0.173
Antibiotics duration	7 (5–11)	10 (8–13)_	<0.046

Note: Data are expressed as number (%) of patients or median (IQR)

Abbreviations: CWI, Charlson weighted index; PSI, pneumonia severity index; ICU, intensive care units; WBC, white blood cells; CRP, C-reactive protein.

Figure 1 Flowchart of study population among patients with early, non-ventilator hospital-acquired pneumonia.

Table 2 Distribution of Single and Multiple Pathogens in 33 Patients with Positive Results of Sputum Culture Among 195 Patients Underwent Sputum Culture

Pathogens	Ceftriaxone Plus Clindamycin (n=22)		Piperacillin/Tazobactam (n=11)
	Total	Resistance to the regimen	Total	Resistance to the regimen
Staphylococcus aureus	16 (8.2)	1^a (0.5)	3 (1.5)	1^b (0.5)
Streptococcus pneumoniae	3 (1.5)	0 (0)	1 (0.5)	0 (0)
Klebsiella pnuemoniae	1 (0.5)	0 (0)	7 (3.6)	0 (0)
Escherichia coli	0 (0)	0 (0)	1 (0.5)	0 (0)
Enterobacter spp.	2 (1)	0 (0)	1 (0.5)	0 (0)
Serratia marcescens	0 (0)	0 (0)	1 (0.5)	0 (0)
Pseudomonas aeruginosa	1 (0.5)	1 (0.5)	0 (0)	0 (0)
Branhamella catarrhalis	1 (0.5)	0 (0)	0 (0)	0 (0)

Notes: Data are expressed as number (%) of patients. ^aResistant to ceftriaxone and clindamycin (methicillin-resistance S. aureus). ^bResistant to oxacillin.

Table 3 Multivariate Analysis of Association Between Baseline Characteristics of Patients and Clinical Outcomes

Variables	Clinical Failure		30-Day All-Cause Mortality
	HR (95% CI)	P value	HR (95% CI)	P value
Sex, male	1.747 (0.816–3.737))	0.026	0.566 (0.112–2.859)	0.491
Ceftriaxone plus clindamycin	3.316 (1.589–6.918)	0.001	2.542 (0.432–14.954)	0.302
Neurologic disease	2.137 (1.075–4.250)	0.030	2.320 (0.394–13.66)	0.352
PSI score ≥91	1.380 (0.697–2.732)	0.355	0.843 (0.169–4.202)	0.835
ICU stays	3.729 (1.436–9.680)	0.007	0.566 (0.112–2.859)	0.491

Abbreviations: CWI, Charlson weighted index; PSI, pneumonia severity index; ICU, intensive care unit.

Figure 2 The Kaplan–Meier curve for clinical improvement analysis for patients with early, non-ventilator hospital-acquired pneumonia, categorized by ceftriaxone plus clindamycin and piperacillin/tazobactam treatment.