Most Read Articles
23 Nov 2018
Initial acute respiratory illness (ARI) admissions related to human adenovirus (HAdV), human metapneumovirus (hMPV) and human rhinovirus (HRV) occurring during early infancy increase the risk of subsequent ARI-related readmission, a recent study has shown.
Jairia Dela Cruz, 08 Jan 2020
In chronic obstructive pulmonary disease (COPD) patients initiating inhaled corticosteroid (ICS)/long-acting β2 agonist (LABA) combinations, both budesonide/formoterol (FOR) dry-powder inhalers and beclomethasone/FOR metered-dose inhalers pose lower risks of severe pneumonia and severe adverse events compared with fluticasone/salmeterol delivered using the same type of inhaler, as reported in a recent study.
Roshini Claire Anthony, 19 Dec 2019

First-line treatment with the epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI) dacomitinib demonstrated persistent survival benefit in patients with EGFR-positive advanced non-small cell lung cancer (NSCLC), according to updated results from the phase III ARCHER 1050* trial.

Pearl Toh, 03 Dec 2018
Sequential treatment with afatinib followed by osimertinib enables prolonged chemotherapy-free treatment while sustaining clinical benefit in patients with EGFR-mutation positive (EGFR+) non-small–cell lung cancer (NSCLC) who acquire T790M mutation, according to the real-world retrospective GioTag study presented at ESMO Asia 2018.

Macrolide de-escalation a reasonable antimicrobial stewardship approach for severe CAP

29 Nov 2019

An antimicrobial stewardship approach of de-escalating from combination therapy with beta-lactam plus macrolide to beta-lactam monotherapy in the management of patients with severe community-acquired pneumonia (CAP) and a negative BioFire FilmArray Respiratory Panel 2 polymerase chain reaction (BioFire PCR) result is reasonable and does not lead to increased in-hospital mortality, according to a recent study.

Instead, de-escalation is associated with decreased length of stay (LOS) in the hospital and intensive care unit (ICU).

The study included 94 critically ill adults with CAP treated for ≥48 hours with combination beta-lactam and azithromycin therapy. Treatment was subsequently de-escalated to beta-lactam monotherapy in 53 patients and was retained in 41 patients.

In-hospital mortality did not significantly differ between the de-escalation and control group (2.4 percent vs 11.3 percent, respectively; p=0.312). However, patients in the de-escalated group had shorter ICU (1.9 vs 3.4 days; p=0.029) and hospital LOS (6 vs 7 days; p=0.025).

Likewise, there were no significant differences observed with respect to additional secondary endpoints, including duration of mechanical ventilatory support, 30-day readmission and incidence of azithromycin-related adverse effects.

Simple logistic regression confirmed that there was no association between de-escalation and hospital mortality (odds ratio, 0.17, 95 percent confidence interval [CI], 0.02–1.70).

“Our results suggest that macrolide de-escalation in the setting of a negative BioFire PCR result may be a reasonable approach to antimicrobial stewardship in the severe CAP population; however, larger, prospective studies are warranted to fully explain this association,” the researchers said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
23 Nov 2018
Initial acute respiratory illness (ARI) admissions related to human adenovirus (HAdV), human metapneumovirus (hMPV) and human rhinovirus (HRV) occurring during early infancy increase the risk of subsequent ARI-related readmission, a recent study has shown.
Jairia Dela Cruz, 08 Jan 2020
In chronic obstructive pulmonary disease (COPD) patients initiating inhaled corticosteroid (ICS)/long-acting β2 agonist (LABA) combinations, both budesonide/formoterol (FOR) dry-powder inhalers and beclomethasone/FOR metered-dose inhalers pose lower risks of severe pneumonia and severe adverse events compared with fluticasone/salmeterol delivered using the same type of inhaler, as reported in a recent study.
Roshini Claire Anthony, 19 Dec 2019

First-line treatment with the epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI) dacomitinib demonstrated persistent survival benefit in patients with EGFR-positive advanced non-small cell lung cancer (NSCLC), according to updated results from the phase III ARCHER 1050* trial.

Pearl Toh, 03 Dec 2018
Sequential treatment with afatinib followed by osimertinib enables prolonged chemotherapy-free treatment while sustaining clinical benefit in patients with EGFR-mutation positive (EGFR+) non-small–cell lung cancer (NSCLC) who acquire T790M mutation, according to the real-world retrospective GioTag study presented at ESMO Asia 2018.