{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:48:18Z","timestamp":1785232098112,"version":"3.55.0"},"reference-count":42,"publisher":"European Respiratory Society (ERS)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2006,1,18]]},"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:p>To determine the impact of initial antimicrobial choice on 30-day mortality rate in patients with community-acquired pneumonia due to<jats:italic>Streptococcus pneumoniae<\/jats:italic>(CAP-SP), a prospective, observational study was conducted in 35 Spanish hospitals. A total of 638 patients with CAP-SP were identified. Antimicrobials were chosen by the attending physician. Patients were grouped into the following categories: \u03b2-lactam monotherapy (n\u200a=\u200a251), macrolide monotherapy (n\u200a=\u200a37), \u03b2-lactam plus macrolide (n\u200a=\u200a198), levofloxacin alone\/combination (n\u200a=\u200a48), and other combinations (n\u200a=\u200a104). The reference category was \u03b2-lactam+macrolide.<\/jats:p><jats:p>The 30-day survival probability was 84.9%. Using multivariate survival analysis, factors related to mortality in the entire population were: bilateral disease, suspected aspiration, shock, HIV infection, renal failure and pneumonia severity index (PSI) score Class IV<jats:italic>versus<\/jats:italic>I\u2013III and categories V<jats:italic>versus<\/jats:italic>I\u2013III. The association of \u03b2-lactams+macrolides was not better than the use of \u03b2-lactams alone. The current authors analysed the different groups of patients with significant mortality\/morbidity: intensive care unit, PSI Class &gt;III, renal failure, chronic lung disease and bacteraemia. Only in patients with PSI Class &gt;III, who had undergone initial antimicrobial choice classified as other combinations, were associated with higher mortality.<\/jats:p><jats:p>In conclusion, the current authors have not demonstrated an independent association between initial antimicrobial regimen and 30-day mortality in community-acquired pneumococcal pneumonia patients, except for those with a higher pneumonia severity index score.<\/jats:p>","DOI":"10.1183\/09031936.06.00126004","type":"journal-article","created":{"date-parts":[[2006,2,3]],"date-time":"2006-02-03T01:58:01Z","timestamp":1138931881000},"page":"1010-1019","source":"Crossref","is-referenced-by-count":71,"title":["Impact of initial antibiotic choice on mortality from pneumococcal pneumonia"],"prefix":"10.1183","volume":"27","author":[{"given":"J.","family":"Aspa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Rajas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Rodriguez de Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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