Source
Journal ‘Clinical Microbiology and Infection’ – Editora Elsevier
Authors
Claudia Figueiredo-Mello, Pontus Naucler, Marinella Della Negra e Anna S. Levin
Abstract
Objectives:To evaluate if treatment with ceftriaxone and a macrolide, improved patient outcome whencompared with monotherapy with ceftriaxone, in hospitalized patients with human immunodeficiencyvirus/acquired immunodeficient syndrome (HIV/AIDS) with community-acquired pneumonia (CAP).Methods:Adult patients with HIV hospitalized due to suspected CAP were randomized to receive one oftwo regimens, ceftriaxone plus macrolide or ceftriaxone plus placebo, at a 1:1 proportion (BrazilianClinical Trials Registry: RBR-8wtq2b). The primary outcome was in-hospital mortality and the secondaryoutcomes were mortality within 14 days, need for vasoactive drugs, need for mechanical ventilation,time to clinical stability and length of hospitalization.Results:A total of 227 patients were randomized, two were excluded after randomization; 225 patientswere analysed (112 receiving ceftriaxone plus placebo and 113 receiving ceftriaxone plus macrolide). Thefrequency of the primary outcome, in-hospital mortality, was not statistically different between theregimens: 12/112 (11%) patients who received ceftriaxone plus placebo and 17/113 (15%) who receivedceftriaxone plus macrolide died during hospitalization (hazard ratio 1.22, 95% CI 0.57e2.59). We did notfind differences between the regimens for any of the secondary outcomes, including mortality within14 days, which occurred in 5/112 (4%) patients with ceftriaxone plus placebo and in 12/113 (11%) patientswith ceftriaxone plus macrolide (relative risk 2.38, 95% CI 0.87e6.53).Conclusions:Among hospitalized patients with HIV/AIDS with CAP, treatment with ceftriaxone and amacrolide did not improve patient outcomes, when compared with ceftriaxone monotherapy.
Ceftriaxone versus ceftriaxone plus a macrolide for community-acquired pneumonia in hospitalized patients with HIV/AIDS : a randomized controlled trial
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