{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:10:04Z","timestamp":1730679004961,"version":"3.28.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sepsis and pneumonia in the elderly comprise a significant portion of medical admissions. Chloramphenicol has been used in Israel for treatment of bacterial infections, without evidence regarding its efficacy and safety.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We aimed to examine whether chloramphenicol was associated with similar outcomes to ceftriaxone, for treatment of sepsis and pneumonia in the elderly with dementia and functional disability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients over 75, with dementia and functional disability, admitted to the internal medicine ward at Beilinson Hospital between 2011 and 2021, with community-acquired aspiration pneumonia or sepsis of undetermined source were included. Patients with mild dementia and independent in their activities of daily living were excluded. Primary outcome was 30- and 90-day all-cause mortality. A propensity-weighted multivariable model was constructed using inverse probability of treatment weighting. Results were expressed as OR with 95% CI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 1558 patients were included: 512 treated with chloramphenicol and 1046 with ceftriaxone. The cohort consisted of elderly patients (mean age 87\u200a\u00b1\u200a6.2\u2005years) with comorbidities; 30- and 90-day all-cause mortality were similar [222\/512 (43.3%) versus 439\/1046 (41.9%) P\u200a=\u200a0.602, and 261\/512 (50.9%) versus 556\/1046 (53.1%) P\u200a=\u200a0.419, respectively]. Propensity-weighted, logistic multivariable analysis for 30- and 90-day all-cause mortality revealed similar mortality rates for chloramphenicol and ceftriaxone (OR 1.049 95% CI 0.217\u20131.158, OR 0.923 95% CI 0.734\u20131.112, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this retrospective cohort of elderly debilitated patients hospitalized with pneumonia and sepsis, we found no difference in 30- and 90-day mortality between those treated with chloramphenicol or ceftriaxone. Further studies should determine the efficacy and safety of chloramphenicol in this population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkae323","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T08:12:14Z","timestamp":1727079134000},"page":"3007-3015","source":"Crossref","is-referenced-by-count":0,"title":["Chloramphenicol versus ceftriaxone for the treatment of pneumonia and sepsis in elderly patients with advanced dementia and functional disability. A propensity-weighted retrospective cohort study"],"prefix":"10.1093","volume":"79","author":[{"given":"Y","family":"Eynath","sequence":"first","affiliation":[{"name":"Department of Medicine A, Beilinson Hospital, Rabin Medical Center , Petah-Tikva ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel-Aviv University , Tel-Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"McNeil","sequence":"additional","affiliation":[{"name":"Department of Medicine A, Beilinson Hospital, Rabin Medical Center , Petah-Tikva ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel-Aviv University , Tel-Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Buchrits","sequence":"additional","affiliation":[{"name":"Department of Medicine A, Beilinson Hospital, Rabin Medical Center , Petah-Tikva ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel-Aviv University , Tel-Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Guz","sequence":"additional","affiliation":[{"name":"Department of Medicine A, Beilinson Hospital, Rabin Medical Center , Petah-Tikva ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel-Aviv University , Tel-Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Fredman","sequence":"additional","affiliation":[{"name":"Department of Medicine A, Beilinson Hospital, Rabin Medical Center , Petah-Tikva ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel-Aviv University , Tel-Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Gafter-Gvili","sequence":"additional","affiliation":[{"name":"Department of Medicine A, Beilinson Hospital, Rabin Medical Center , Petah-Tikva ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel-Aviv University , Tel-Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Avni","sequence":"additional","affiliation":[{"name":"Department of Medicine A, Beilinson Hospital, Rabin Medical Center , Petah-Tikva ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel-Aviv University , Tel-Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"2024110323531957700_dkae323-B1","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1111\/j.1532-5415.2008.01712.x","article-title":"Hospital charges attributable to a primary diagnosis of infectious diseases in older adults in the United States, 1998 to 2004","volume":"56","author":"Curns","year":"2008","journal-title":"J Am Geriatr Soc"},{"key":"2024110323531957700_dkae323-B2","doi-asserted-by":"publisher","first-page":"e42751","DOI":"10.1371\/journal.pone.0042751","article-title":"Dementia increases the risks of acute organ dysfunction, severe sepsis and mortality in hospitalized older patients: a national population-based study","volume":"7","author":"Shen","year":"2012","journal-title":"PLoS ONE"},{"key":"2024110323531957700_dkae323-B3","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/j.jcrc.2013.03.018","article-title":"Impact of older age and nursing home residence on clinical outcomes of US emergency department visits for severe sepsis","volume":"28","author":"Ginde","year":"2013","journal-title":"J Crit Care"},{"key":"2024110323531957700_dkae323-B4","doi-asserted-by":"publisher","first-page":"57","DOI":"10.20506\/rst.31.1.2095","article-title":"Antibiotics that affect the ribosome","volume":"31","author":"Lambert","year":"2012","journal-title":"Rev Sci Tech"},{"key":"2024110323531957700_dkae323-B5","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1542\/pir.20.10.357","article-title":"Chloramphenicol","volume":"20","author":"Sills","year":"1999","journal-title":"Pediatr Rev"},{"key":"2024110323531957700_dkae323-B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jiac.2015.10.010","article-title":"Spectrum and treatment of anaerobic infections","volume":"22","author":"Brook","year":"2016","journal-title":"J Infect Chemother"},{"key":"2024110323531957700_dkae323-B7","first-page":"27","article-title":"Chloramphenicol use and susceptibility patterns in Israel: a national survey","volume":"17","author":"Nitzan","year":"2015","journal-title":"Isr Med Assoc J"},{"key":"2024110323531957700_dkae323-B8","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for sepsis and septic shock (sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"2024110323531957700_dkae323-B9","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia. 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