4 results on '"Chalmers, J. D."'
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2. Seven-day antibiotic courses have similar efficacy to prolonged courses in severe community-acquired pneumonia--a propensity-adjusted analysis.
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Choudhury G, Mandal P, Singanayagam A, Akram AR, Chalmers JD, and Hill AT
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- Aged, Aged, 80 and over, Community-Acquired Infections mortality, Female, Humans, Male, Pneumonia, Bacterial mortality, Prospective Studies, Survival Analysis, Time Factors, Treatment Outcome, Anti-Bacterial Agents administration & dosage, Community-Acquired Infections drug therapy, Pneumonia, Bacterial drug therapy
- Abstract
There are no studies to guide the optimal duration of therapy in severe community-acquired pneumonia (CAP). The aim of this study was to determine whether 7 days of antibiotic treatment is equivalent to longer-course therapy in severe CAP. In this prospective observational study, we included patients with severe CAP (CURB65 score 3-5) admitted to the hospital with signs and symptoms consistent with pneumonia. A propensity score, derived through multiple logistic regression, was used to match patients into two groups: treated for 7 days vs. treated for >7 days. Patients who died, were admitted to the intensive-care unit, developed complicated pneumonia, failed to reach clinical stability or had positive cultures for microorganisms requiring prolonged treatment within the first 7 days were excluded. Patients outside the mutual range of the propensity score were also excluded. The primary outcome of this study was 30-day mortality. Secondary outcomes were subsequent requirement for mechanical ventilation and/or inotropic support and the development of complicated pneumonia or re-admission within 30 days. Four hundred and twelve patients were suitable for derivation of the propensity score. After matching on propensity score, 164 patients treated for 7 days were compared with 164 treated for >7 days; they were well matched in terms of age, gender, comorbidities, and physiological parameters. The results showed no significant differences in the primary and the secondary outcomes between the two groups. This study therefore suggests that, in the majority of severe CAP patients who have clinically responded, antibiotics can be safely discontinued at 7 days., (© 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.)
- Published
- 2011
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3. Risk factors for complicated parapneumonic effusion and empyema on presentation to hospital with community-acquired pneumonia.
- Author
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Chalmers JD, Singanayagam A, Murray MP, Scally C, Fawzi A, and Hill AT
- Subjects
- Adult, Aged, Biomarkers blood, Community-Acquired Infections complications, Epidemiologic Methods, Female, Hospitalization, Humans, Male, Middle Aged, Prognosis, Empyema, Pleural microbiology, Pleural Effusion microbiology, Pneumonia, Bacterial complications
- Abstract
Background: The aim of this study was to identify key factors on admission predicting the development of complicated parapneumonic effusion or empyema in patients admitted with community-acquired pneumonia., Methods: A prospective observational study of patients admitted with community-acquired pneumonia in NHS Lothian, UK, was conducted. Multivariate regression analyses were used to evaluate factors that could predict the development of complicated parapneumonic effusion or empyema, including admission demographics, clinical features, laboratory tests and pneumonia-specific (Pneumonia Severity Index (PSI), CURB65 (New onset confusion, urea >7 mmol/l, Respiratory rate > or = 30 breaths/min, Systolic blood pressure < 90 mm Hg and/or diastolic blood pressure < or = 60 mm Hg and age > or = 65 years) and CRB65 (New onset confusion, Respiratory rate > or = 30 breaths/min, Systolic blood pressure <90 mm Hg and/or diastolic blood pressure < or = 60 mm Hg and age > or = 65 years)) and generic sepsis scoring systems (APACHE II (Acute Physiology and Chronic Health Evaluation II), SEWS (standardised early warning score) and systemic inflammatory response syndrome (SIRS))., Results: 1269 patients were included in the study and 92 patients (7.2%) developed complicated parapneumonic effusion or empyema. The pneumonia-specific and generic sepsis scoring systems had no value in predicting complicated parapneumonic effusion or empyema. Multivariate logistic regression identified albumin <30 g/l adjusted odds ratio (AOR) 4.55 (95% CI 2.45 to 8.45, p < 0.0001), sodium <130 mmol/l AOR 2.70 (1.55 to 4.70, p = 0.0005), platelet count >400 x 10(9)/l AOR 4.09 (2.21 to 7.54, p < 0.0001), C-reactive protein >100 mg/l AOR 15.7 (3.69 to 66.9, p < 0.0001) and a history of alcohol abuse AOR 4.28 (1.87 to 9.82, p = 0.0006) or intravenous drug use AOR 2.82 (1.09 to 7.30, p = 0.03) as independently associated with development of complicated parapneumonic effusion or empyema. A history of chronic obstructive pulmonary disease was associated with decreased risk, AOR 0.18 (0.06 to 0.53, p = 0.002). A 6-point scoring system using these combined variables had good discriminatory value: area under the receiver operator characteristic curve (AUC) 0.84 (95% CI 0.81 to 0.86, p < 0.0001)., Conclusion: This study has identified seven clinical factors predicting the development of complicated parapneumonic effusion or empyema. Independent validation is needed.
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- 2009
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4. Carga y factores de riesgo para la neumonía adquirida en la comunidad de Pseudomonas aeruginosa : un estudio multinacional de prevalencia puntual de pacientes hospitalizados
- Author
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Restrepo M. I., Babu B. L., Reyes L. F., Chalmers J. D., Soni N. J., Sibila O., Faverio P., Cilloniz C., Rodriguez-Cintron W., Aliberti S., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Ceccato A., Chertcoff J., Lascar F., Di Tulio F., Diaz A. C., de Vedia L., Ganaha M. C., Lambert S., Lopardo G., Luna C. M., Malberti A. G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P. G., Stagnaro J. P., Shah S., Lotsch F., Thalhammer F., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Bashi J., Dodo R., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Dodo Balkissou A., Pefura Yone E. W., Mbatchou Ngahane B. H., Shen N., Xu J. F., Bustamante Rico C. A., Buitrago R., Pereira Paternina F. J., Kayembe Ntumba J. M., Carevic V. V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M. L., Bro Christensen A., Heitmann Bodtger U. C., Niels Meyer C., Vestergaard Jensen A., Baunbaek-Knudsen G., Petersen P. T., Andersen S., Abd El-Wahhab I. E., Elsayed Morsy N., Shafiek H., Sobh E., Abdella Abdulsemed K., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P. A., Mahesh P. A., Jayaraj B. S., Narayan K. V., Udnur H. B., Krishnamurthy S. B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Martin-Loeches I., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M. A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z. A., Ugalde D. B., Zuniga O. C., Villegas J. F., Medenica M., van de Garde E. M. W., Raj Mihsra D., Shrestha P., Ridgeon E., Awokola B. I., Nwankwo O. N. O., Olufunlola A. B., Olumide S., Ukwaja K. N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Ravara S. B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z. A., Edathodu J., Fathy A., Abdulaziz Enani A. M., Mohamed N. E., Memon J. U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Feldman C., Yum H. K., Borderias L., Bordon Garcia N. M., Cabello Alarcon H., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Gallego M., Gaspar-Garcia I., Del Castillo J. G., Victoria P. J., Martinez E. L., de Molina R. M., Marcos P. J., Menendez R., Pando-Sandoval A., Aymerich C. P., de la Torre A. L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F. M., Torra E. V., Pujol J. A., Fiogbe A. A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D. J., Feneley A., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Allen K. S., Brito V., Dietz J., Dysart C. E., Kellie S. M., Zablocki C. J., MurphyMurphy R. G., Franco-Sadud R. A., Meier G., Gaga M., Holland T. L., Bergin S. P., Kheir F., Landmeier M., Lois M., Nair G. B., Patel H., Saito S., Noda J., Hinojosa C. I., Levine S. M., Angel L. F., Anzueto A., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Wunderink R. G., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., Labra L., Restrepo, M. I., Babu, B. L., Reyes, L. F., Chalmers, J. D., Soni, N. J., Sibila, O., Faverio, P., Cilloniz, C., Rodriguez-Cintron, W., Aliberti, S., Aruj, P. K., Attorri, S., Barimboim, E., Caeiro, J. P., Garzon, M. I., Cambursano, V. H., Ceccato, A., Chertcoff, J., Lascar, F., Di Tulio, F., Diaz, A. C., de Vedia, L., Ganaha, M. C., Lambert, S., Lopardo, G., Luna, C. M., Malberti, A. G., Morcillo, N., Tartara, S., Pensotti, C., Pereyra, B., Scapellato, P. G., Stagnaro, J. P., Shah, S., Lotsch, F., Thalhammer, F., Anseeuw, K., Francois, C. A., Van Braeckel, E., Vincent, J. L., Djimon, M. Z., Bashi, J., Dodo, R., Nouer, S. A., Chipev, P., Encheva, M., Miteva, D., Petkova, D., Dodo Balkissou, A., Pefura Yone, E. W., Mbatchou Ngahane, B. H., Shen, N., Xu, J. F., Bustamante Rico, C. A., Buitrago, R., Pereira Paternina, F. J., Kayembe Ntumba, J. M., Carevic, V. V., Jakopovic, M., Jankovic, M., Matkovic, Z., Mitrecic, I., Bouchy Jacobsson, M. L., Bro Christensen, A., Heitmann Bodtger, U. C., Niels Meyer, C., Vestergaard Jensen, A., Baunbaek-Knudsen, G., Petersen, P. T., Andersen, S., Abd El-Wahhab, I. E., Elsayed Morsy, N., Shafiek, H., Sobh, E., Abdella Abdulsemed, K., Bertrand, F., Brun-Buisson, C., de Montmollin, E., Fartoukh, M., Messika, J., Tattevin, P., Khoury, A., Ebruke, B., Dreher, M., Kolditz, M., Meisinger, M., Pletz, M. W., Hagel, S., Rupp, J., Schaberg, T., Spielmanns, M., Creutz, P., Suttorp, N., Siaw-Lartey, B., Dimakou, K., Papapetrou, D., Tsigou, E., Ampazis, D., Kaimakamis, E., Bhatia, M., Dhar, R., D'Souza, G., Garg, R., Koul, P. A., Mahesh, P. A., Jayaraj, B. S., Narayan, K. V., Udnur, H. B., Krishnamurthy, S. B., Kant, S., Swarnakar, R., Limaye, S., Salvi, S., Golshani, K., Keatings, V. M., Martin-Loeches, I., Maor, Y., Strahilevitz, J., Battaglia, S., Carrabba, M., Ceriana, P., Confalonieri, M., Monforte, A. D., Del Prato, B., De Rosa, M., Fantini, R., Fiorentino, G., Gammino, M. A., Menzella, F., Milani, G., Nava, S., Palmiero, G., Petrino, R., Gabrielli, B., Rossi, P., Sorino, C., Steinhilber, G., Zanforlin, A., Franzetti, F., Carugati, M., Morosi, M., Monge, E., Carone, M., Patella, V., Scarlata, S., Comel, A., Kurahashi, K., Bacha, Z. A., Ugalde, D. B., Zuniga, O. C., Villegas, J. F., Medenica, M., van de Garde, E. M. W., Raj Mihsra, D., Shrestha, P., Ridgeon, E., Awokola, B. I., Nwankwo, O. N. O., Olufunlola, A. B., Olumide, S., Ukwaja, K. N., Irfan, M., Minarowski, L., Szymon, S., Froes, F., Leuschner, P., Meireles, M., Ferrao, C., Neves, J., Ravara, S. B., Brocovschii, V., Ion, C., Rusu, D., Toma, C., Chirita, D., Dorobat, C. M., Birkun, A., Kaluzhenina, A., Almotairi, A., Ali Bukhary, Z. A., Edathodu, J., Fathy, A., Abdulaziz Enani, A. M., Mohamed, N. E., Memon, J. U., Bella, A., Bogdanovic, N., Milenkovic, B., Pesut, D., Feldman, C., Yum, H. K., Borderias, L., Bordon Garcia, N. M., Cabello Alarcon, H., Torres, A., Diaz-Brito, V., Casas, X., Gonzalez, A. E., Fernandez-Almira, M. L., Gallego, M., Gaspar-Garcia, I., Del Castillo, J. G., Victoria, P. J., Martinez, E. L., de Molina, R. M., Marcos, P. J., Menendez, R., Pando-Sandoval, A., Aymerich, C. P., de la Torre, A. L., Garcia-Olive, I., Rello, J., Moyano, S., Sanz, F., Rodrigo-Troyano, A., Sole-Violan, J., Uranga, A., van Boven, J. F. M., Torra, E. V., Pujol, J. A., Fiogbe, A. A., Yangui, F., Bilaceroglu, S., Dalar, L., Yilmaz, U., Bogomolov, A., Elahi, N., Dhasmana, D. J., Feneley, A., Ions, R., Skeemer, J., Woltmann, G., Hancock, C., Hill, A. T., Rudran, B., Ruiz-Buitrago, S., Campbell, M., Whitaker, P., Youzguin, A., Singanayagam, A., Allen, K. S., Brito, V., Dietz, J., Dysart, C. E., Kellie, S. M., Zablocki, C. J., Murphymurphy, R. G., Franco-Sadud, R. A., Meier, G., Gaga, M., Holland, T. L., Bergin, S. P., Kheir, F., Landmeier, M., Lois, M., Nair, G. B., Patel, H., Saito, S., Noda, J., Hinojosa, C. I., Levine, S. M., Angel, L. F., Anzueto, A., Whitlow, K. S., Hipskind, J., Sukhija, K., Totten, V., Wunderink, R. G., Shah, R. D., Mateyo, K. J., Noriega, L., Alvarado, E., Aman, M., Labra, L., Restrepo, M, Babu, B, Reyes, L, Chalmers, J, Soni, N, Sibila, O, Faverio, P, Cilloniz, C, Rodriguez-Cintron, W, Aliberti, S, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Groningen Research Institute for Asthma and COPD (GRIAC), Restrepo M.I., Babu B.L., Reyes L.F., Chalmers J.D., Soni N.J., Sibila O., Faverio P., Cilloniz C., Rodriguez-Cintron W., Aliberti S., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano V.H., Ceccato A., Chertcoff J., Lascar F., Di Tulio F., Diaz A.C., de Vedia L., Ganaha M.C., Lambert S., Lopardo G., Luna C.M., Malberti A.G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P.G., Stagnaro J.P., Shah S., Lotsch F., Thalhammer F., Anseeuw K., Francois C.A., Van Braeckel E., Vincent J.L., Djimon M.Z., Bashi J., Dodo R., Nouer S.A., Chipev P., Encheva M., Miteva D., Petkova D., Dodo Balkissou A., Pefura Yone E.W., Mbatchou Ngahane B.H., Shen N., Xu J.F., Bustamante Rico C.A., Buitrago R., Pereira Paternina F.J., Kayembe Ntumba J.M., Carevic V.V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M.L., Bro Christensen A., Heitmann Bodtger U.C., Niels Meyer C., Vestergaard Jensen A., Baunbaek-Knudsen G., Petersen P.T., Andersen S., Abd El-Wahhab I.E., Elsayed Morsy N., Shafiek H., Sobh E., Abdella Abdulsemed K., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P.A., Mahesh P.A., Jayaraj B.S., Narayan K.V., Udnur H.B., Krishnamurthy S.B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A.D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M.A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z.A., Ugalde D.B., Zuniga O.C., Villegas J.F., Medenica M., van de Garde E.M.W., Raj Mihsra D., Shrestha P., Ridgeon E., Awokola B.I., Nwankwo O.N.O., Olufunlola A.B., Olumide S., Ukwaja K.N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Ravara S.B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C.M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z.A., Edathodu J., Fathy A., Abdulaziz Enani A.M., Mohamed N.E., Memon J.U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Feldman C., Yum H.K., Borderias L., Bordon Garcia N.M., Cabello Alarcon H., Torres A., Diaz-Brito V., Casas X., Gonzalez A.E., Fernandez-Almira M.L., Gallego M., Gaspar-Garcia I., Del Castillo J.G., Victoria P.J., Martinez E.L., de Molina R.M., Marcos P.J., Menendez R., Pando-Sandoval A., Aymerich C.P., de la Torre A.L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F.M., Torra E.V., Pujol J.A., Fiogbe A.A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D.J., Feneley A., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A.T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Allen K.S., Brito V., Dietz J., Dysart C.E., Kellie S.M., Zablocki C.J., MurphyMurphy R.G., Franco-Sadud R.A., Meier G., Gaga M., Holland T.L., Bergin S.P., Kheir F., Landmeier M., Lois M., Nair G.B., Patel H., Saito S., Noda J., Hinojosa C.I., Levine S.M., Angel L.F., Anzueto A., Whitlow K.S., Hipskind J., Sukhija K., Totten V., Wunderink R.G., Shah R.D., Mateyo K.J., Noriega L., Alvarado E., Aman M., and Labra L.
- Subjects
Pneumonia, Pseudomonas aeruginosa ,Male ,antibiotic resistance ,Internationality ,Cross-sectional study ,bacterial colonization ,very elderly ,Prevalence ,Drug Resistance ,Drug resistance ,Pneumònia adquirida a la comunitat ,Pseudomonas aeruginosa community acquired pneumonia ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Tracheostomy ,Community-acquired pneumonia ,Risk Factors ,Epidemiology ,80 and over ,Medicine ,Community-Acquired Infection ,030212 general & internal medicine ,Aged, 80 and over ,Cross Infection ,adult ,article ,Bacterial ,Middle Aged ,Antibiotic coverage ,Bronchiectasis ,Community-Acquired Infections ,hospital patient ,priority journal ,risk factor ,Aged ,Cross-Sectional Studies ,Drug Resistance, Bacterial ,Female ,Humans ,Logistic Models ,Pneumonia, Bacterial ,Pseudomonas aeruginosa ,Infectious diseases ,Human ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Chronic Obstructive ,Logistic Model ,Admission ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,chronic lung disease ,Pulmonary Disease ,03 medical and health sciences ,Bronchiectasi ,Internal medicine ,Pseudomonas ,controlled study ,human ,Cross-Sectional Studie ,business.industry ,Risk Factor ,community acquired pneumonia ,Pneumonia ,medicine.disease ,logistic regression analysis ,major clinical study ,antibiotic sensitivity ,hospital admission ,030228 respiratory system ,microbiological examination ,business ,chronic obstructive lung disease - Abstract
Pseudomonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP. The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases. The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients.
- Published
- 2018
- Full Text
- View/download PDF
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