Macrolides Improve Survival in Severe Community-Acquired Pneumonia

Combination antibiotic treatment improves outcomes among critically ill patients with community-acquired pneumonia (CAP). The 2007 Infectious Diseases Society of America/American Thoracic Society guidelines recommend adding a macrolide or a fluoroquinolone to a β-lactam. However, whether the benefit of such regimens derives from combination therapy or from the use of macrolides rather than fluoroquinolones remains unclear. To explore the latter issue, researchers studied 218 intubated patients with severe CAP (mean age, 60) who were participating in a prospective observational cohort investigation. The original study, conducted in 27 intensive care units (ICUs) in nine European countries, involved 2436 immunocompetent patients who needed in…