Adv Respir Med. 2021 Jul 16. doi: 10.5603/ARM.a2021.0070. Online ahead of print.
INTRODUCTION: We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with β-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course.
MATERIAL AND METHODS: A prospective observational study was conducted at the Pulmonology and Allergology Department in a tertiary care university hospital. 253 consecutive patients diagnosed with CAP requiring hospitalisation were enrolled. Hospital admission was based on PSI or CRB-65 scores, severe comorbidities, signs of intoxication, aspiration risk, social risk considerations, ineffective prior antibiotic treatment.
RESULTS: Fourty seven percent of the subjects had complications on admission, 13% developed new CAP complications during inpatient treatment. Overall, 53% of individuals had a complicated CAP course. 30-day mortality rate was 5.9%. The factors predicting a complicated CAP course were as follows: neuromuscular disease, multilobar opacities on chest X-ray (or computed tomography), and clinically unstable condition as evaluated using Halm's criteria.
CONCLUSIONS: The mortality rate in CAP patients treated with b-lactam monotherapy is low. Neuromuscular disease, multilobar opacities, and clinically unstable condition as evaluated using Halm's criteria predict a complicated CAP course.