Macrolide resistance doesn't impact pneumonia outcomes

(HealthDay)—Patients hospitalized with macrolide-resistant Streptococcus pneumoniae pneumonia are not more severely ill and do not have worse outcomes, according to a study published in the June 1 issue of the American Journal of Respiratory and Critical Care Medicine.

Catia Cilloniz, Ph.D., from the University of Barcelona in Spain, and colleagues examined the effect of macrolide resistance on the presentation and outcomes of patients with pneumococcal pneumonia. Data were reviewed from all adult patients who had positive cultures for S. pneumoniae from January 2000 through December 2013.

The researchers identified 643 patients hospitalized for S. pneumoniae pneumonia, of whom 22 percent were macrolide resistant. Patients with macrolide-resistant organisms were less likely to require mechanical ventilation and to have bacteremia, pulmonary complications, and shock. Patients with macrolide-resistant S. pneumoniae pneumonia had no increase in the incidence of acute renal failure, frequency of intensive care unit admissions, need for invasive ventilator support, length of hospital stay, or 30-day mortality. Macrolide-resistant S. pneumoniae pneumonia had no effect on outcomes as a function of whether treatment regimens were compliant with the guidelines.

"We found no evidence suggesting that patients hospitalized for macrolide-resistant S. pneumoniae pneumonia were more severely ill on presentation or had worse clinical outcomes if they were treated with guideline-compliant versus noncompliant regimens," the authors write.

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