Poor pneumonia outcomes tied to overuse of broad-spectrum antibiotics

Overuse of broad-spectrum antibiotics is associated with increased mortality and other poor outcomes in adults admitted for community-onset pneumonia, according to a study published in the July 1 issue of the European Respiratory Journal.

Brandon J. Webb, M.D., from the Intermountain Medical Center in Murray, Utah, and colleagues evaluated the effect of broad-spectrum antibiotics on outcomes for 1,995 adults with community-onset pneumonia admitted to the hospital from four U.S. hospital emergency departments.

The researchers note that 39.7 percent of patients received broad-spectrum antibiotics. There was an association between broad-spectrum antibiotics and increased mortality in both the unweighted multivariable model (odds ratio [OR], 3.8) and inverse-probability of treatment weighting analysis (odds ratio, 4.6). Both analyses showed that broad-spectrum antibiotic use was also associated with longer hospital stay, greater cost, and increased Clostridioides difficile infection. Manual review revealed antibiotic-associated events were present in 17.5 percent of mortality cases.

"These results lend additional support for more judicious use of broad-spectrum antibiotics in community-onset pneumonia," the authors write.