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1g versus 2?g daily intravenous ceftriaxone in the treatment of community onset pneumonia - a propensity score analysis of data from a Japanese multicenter registry.

ABSTRACT: BACKGROUND:Community-onset pneumonia (COP) is a combined concept of community acquired pneumonia and the previous classification of healthcare-associated pneumonia. Although ceftriaxone (CRO) is one of the treatment choices for COP, it is unclear whether 1 or 2?g CRO daily has better efficacy. We compared the effectiveness of 1?g with 2?g of CRO for COP treatment. We hypothesized that 1?g CRO would show non-inferiority over 2?g CRO. METHODS:This study was an analysis of prospectively registered data of the patients with COP from four Japanese hospitals (the Adult Pneumonia Study Group-Japan: APSG-J). We included subjects who were initially treated solely with 1 or 2?g of CRO. The propensity score was estimated from the 33 pre-treatment variables, including age, sex, weight, pre-existing comorbidities, prescribed drugs, risk factors for aspiration pneumonia, vital signs, laboratory data, and a finding from chest xrays. The primary endpoint was the cure rate, for which a non-inferiority analysis was performed with a margin of 0.05. In addition, we performed three sensitivity analyses; using data limited to the group in which CRO solely was used until the completion of treatment, using data limited to inpatient cases, and performing a generalized linear mixed-effect logistic regression analysis to assess the primary outcome after adjusting for random hospital effects. RESULTS:Of the 3817 adult subjects with pneumonia who were registered in the APSG-J study, 290 and 216 were initially treated solely with 1 or 2?g of CRO, respectively. Propensity score matching was used to extract 175 subjects in each group. The cure rate was 94.6 and 93.1% in the 1 and 2?g CRO groups, respectively (risk difference 1.5%; 95% confidence interval -?3.1 to 6.0; p?=?0.009 for non-inferiority). The results of the sensitivity analyses were consistent with the primary result. CONCLUSIONS:The propensity score-matched analysis of multicenter cohort data from Japan revealed that the cure rate for COP patients treated with 1?g daily CRO was non-inferior to that of patients treated with 2 g daily CRO.

SUBMITTER: Hasegawa S

PROVIDER: S-EPMC6933656 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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1g versus 2 g daily intravenous ceftriaxone in the treatment of community onset pneumonia - a propensity score analysis of data from a Japanese multicenter registry.

Hasegawa Shinya S Sada Ryuichi R Yaegashi Makito M Morimoto Konosuke K Mori Takahiro T

BMC infectious diseases 20191226 1

<h4>Background</h4>Community-onset pneumonia (COP) is a combined concept of community acquired pneumonia and the previous classification of healthcare-associated pneumonia. Although ceftriaxone (CRO) is one of the treatment choices for COP, it is unclear whether 1 or 2 g CRO daily has better efficacy. We compared the effectiveness of 1 g with 2 g of CRO for COP treatment. We hypothesized that 1 g CRO would show non-inferiority over 2 g CRO.<h4>Methods</h4>This study was an analysis of prospectiv ...[more]

PMID: 31878894

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Dataset Information

1g versus 2?g daily intravenous ceftriaxone in the treatment of community onset pneumonia - a propensity score analysis of data from a Japanese multicenter registry.

Publications

1g versus 2 g daily intravenous ceftriaxone in the treatment of community onset pneumonia - a propensity score analysis of data from a Japanese multicenter registry.

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