{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T02:09:55Z","timestamp":1781834995023,"version":"3.54.5"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T00:00:00Z","timestamp":1582675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Cempra Pharmaceuticals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Antibiotic treatment failure is common among patients with community-acquired pneumonia (CAP) who are managed in the outpatient setting and is associated with higher mortality and increased health care costs. This study\u2019s objectives were to quantify the occurrence of antibiotic treatment failure (ATF) and to evaluate clinical and economic outcomes between CAP patients who experienced ATF relative to those who did not.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective analysis of the MarketScan Commercial &amp; Medicare Supplemental Databases was performed, identifying patients \u226518 years old, with a pneumonia diagnosis in the outpatient setting, and who received a fluoroquinolone, macrolides, beta-lactam, or tetracycline. ATF was defined as any of the following events within 30 days of initial antibiotic: antibiotic refill, antibiotic switch, emergency room visit, or hospitalization. Outcomes included 30-day all-cause mortality and CAP-related health care costs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During the study period, 251 947 unique patients met inclusion criteria. The mean age was 52.2 years, and 47.7% were male. The majority of patients received a fluoroquinolone (44.4%) or macrolide (43.6%). Overall, 22.1% were classified as ATFs. Among 18\u201364-year-old patients, 21.2% experienced treatment failure, compared with 25.7% in those &amp;gt;65 years old. All-cause mortality was greater in the antibiotic failure group relative to the non\u2013antibiotic failure group (18.1% vs 4.6%, respectively), and the differences in 30-day mortality between antibiotic failure groups increased as a function of age. Mean 30-day CAP-related health care costs were also higher in the patients who experienced treatment failure relative to those who did not ($2140 vs $54, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Treatment failure and poor outcomes from outpatient CAP are common with current guideline-concordant CAP therapies. Improvements in clinical management programs and therapeutic options are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaa065","type":"journal-article","created":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T07:34:39Z","timestamp":1582702479000},"source":"Crossref","is-referenced-by-count":22,"title":["Antibiotic Treatment Failure and Associated Outcomes Among Adult Patients With Community-Acquired Pneumonia in the Outpatient Setting: A Real-world US Insurance Claims Database Study"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2221-008X","authenticated-orcid":false,"given":"Glenn","family":"Tillotson","sequence":"first","affiliation":[{"name":"GST Micro LLC, Henrico, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lodise","sequence":"first","affiliation":[{"name":"Albany School of Pharmacy and Health Sciences, Albany, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Classi","sequence":"first","affiliation":[{"name":"Cempra Pharmaceuticals, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Mildvan","sequence":"first","affiliation":[{"name":"Icahn School of Medicine, Mount Sinai Hospital, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A","family":"McKinnell","sequence":"first","affiliation":[{"name":"David Geffen School of Medicine, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,26]]},"reference":[{"key":"2020031612072804400_CIT0001","doi-asserted-by":"crossref","first-page":"130","DOI":"10.3810\/pgm.2010.03.2130","article-title":"Burden of community-acquired pneumonia in North American adults","volume":"122","author":"File","year":"2010","journal-title":"Postgrad Med"},{"key":"2020031612072804400_CIT0002"},{"key":"2020031612072804400_CIT0003","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s40258-013-0026-0","article-title":"Community-acquired pneumonia episode costs by age and risk in commercially insured US adults aged \u226550 years","volume":"11","author":"Sato","year":"2013","journal-title":"Appl Health Econ Health Policy"},{"key":"2020031612072804400_CIT0004","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1111\/j.1532-5415.2012.04208.x","article-title":"Clinical and economic burden of community-acquired pneumonia in the Medicare fee-for-service population","volume":"60","author":"Yu","year":"2012","journal-title":"J Am Geriatr Soc"},{"key":"2020031612072804400_CIT0005","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. adults","volume":"373","author":"Jain","year":"2015","journal-title":"N Engl J Med"},{"key":"2020031612072804400_CIT0006","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s12877-018-0787-2","article-title":"The relative burden of community-acquired pneumonia hospitalizations in older adults: a retrospective observational study in the United States","volume":"18","author":"Brown","year":"2018","journal-title":"BMC Geriatr"},{"key":"2020031612072804400_CIT0007","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s15010-015-0789-3","article-title":"Clinical and economic burden of community-acquired pneumonia in the Veterans Health Administration, 2011: a retrospective cohort study","volume":"43","author":"McLaughlin","year":"2015","journal-title":"Infection"},{"key":"2020031612072804400_CIT0008","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. adults","volume":"373","author":"Jain","year":"2015","journal-title":"N Engl J Med"},{"key":"2020031612072804400_CIT0009","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1007\/s12325-010-0062-1","article-title":"Comparative antibiotic failure rates in the treatment of community-acquired pneumonia: results from a claims analysis","volume":"27","author":"Hess","year":"2010","journal-title":"Adv Ther"},{"key":"2020031612072804400_CIT0010","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.clinthera.2008.01.023","article-title":"Treatment failure rates and health care utilization and costs among patients with community-acquired pneumonia treated with levofloxacin or macrolides in an outpatient setting: a retrospective claims database analysis","volume":"30","author":"Ye","year":"2008","journal-title":"Clin Ther"},{"key":"2020031612072804400_CIT0011","first-page":"1","article-title":"Ambulatory medical care utilization estimates for 2007","author":"Schappert","year":"2011; 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