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Ceftriaxone versus ceftriaxone plus a macrolide for community acquired pneumonia in hospitalized patients with HIV/AIDS: a randomized controlled trial.
Clin Microbiol Infect. 2017 Jun 22;:
Authors: Figueiredo-Mello C, Naucler P, Negra MD, Levin AS
Abstract
OBJECTIVES: Evaluate if treatment with ceftriaxone and a macrolide, improved patient outcome when compared with monotherapy with ceftriaxone, in hospitalized patients with HIV/AIDS with community-acquired pneumonia (CAP).
METHODS: Adult patients with HIV hospitalized due to suspected CAP were randomized to receive one of two regimens, ceftriaxone plus macrolide or ceftriaxone plus placebo, at a 1:1 proportion (Brazilian Clinical Trials Registry: RBR-8wtq2b). The primary outcome was in-hospital mortality and the secondary outcomes were mortality within 14 days, need for vasoactive drugs, need for mechanical ventilation, time to clinical stability and length of hospitalization.
RESULTS: 227 patients were randomized, 2 were excluded after randomization. A total of 225 patients were analysed (112 receiving ceftriaxone plus placebo and 113 receiving ceftriaxone plus macrolide). The frequency of the primary outcome, in-hospital mortality, was not statistically different between the regimens: 12/112 (11%) patients who received ceftriaxone plus placebo and 17/113 (15%) who received ceftriaxone plus macrolide died during hospitalization (HR: 1.22, 95% CI: 0.57-2.59). We did not find differences between the regimens for any of the secondary outcomes, including mortality within 14 days, which occurred in 5/112 (4%) patients with ceftriaxone plus placebo and in 12/113 (11%) patients with ceftriaxone plus macrolide (RR: 2.38, 95% CI: 0.87-6.53).
CONCLUSIONS: Among hospitalized patients with HIV/AIDS with CAP, treatment with ceftriaxone and a macrolide did not improve patient outcomes, when compared with ceftriaxone monotherapy.
PMID: 28648859 [PubMed - as supplied by publisher]