Key clinical point: Patients with rheumatoid arthritis (RA) who are not obese, those who have high initial disease activity, and those with long disease duration are more responsive to tumor necrosis factor (TNF) inhibitors.

Major finding: The risk for European League Against Rheumatism nonresponse was significantly higher in patients with obesity vs. those with a body mass index of <30 kg/m² (odds ratio 0.52 vs. 0.36; P = .01). Among patients treated with TNF inhibitors, the final Disease Activity Score on 28 joints-C-reactive protein (DAS28-CRP) decreased by 0.02 each year of disease duration (P < .001), with a reduction of 0.21 in patients with a baseline DAS28-CRP of >5.1 (P = .05).

Study details: This was a pooled analysis of individual patient data of 11,617 patients with RA from 29 randomized controlled trials.

Disclosures: This work was partly supported by the French Higher Education and Research Ministry. P Goupille and D Mulleman declared serving as a consultant or speaker, participating in international congresses or clinical trials, and receiving grants from various sources.

Source: Law-Wan J et al. RMD Open. 2021;7(3):e001882 (Nov 17). Doi: 10.1136/rmdopen-2021-001882.

Key clinical point: Patients with rheumatoid arthritis (RA) who are not obese, those who have high initial disease activity, and those with long disease duration are more responsive to tumor necrosis factor (TNF) inhibitors.

Major finding: The risk for European League Against Rheumatism nonresponse was significantly higher in patients with obesity vs. those with a body mass index of <30 kg/m² (odds ratio 0.52 vs. 0.36; P = .01). Among patients treated with TNF inhibitors, the final Disease Activity Score on 28 joints-C-reactive protein (DAS28-CRP) decreased by 0.02 each year of disease duration (P < .001), with a reduction of 0.21 in patients with a baseline DAS28-CRP of >5.1 (P = .05).

Study details: This was a pooled analysis of individual patient data of 11,617 patients with RA from 29 randomized controlled trials.

Disclosures: This work was partly supported by the French Higher Education and Research Ministry. P Goupille and D Mulleman declared serving as a consultant or speaker, participating in international congresses or clinical trials, and receiving grants from various sources.

Source: Law-Wan J et al. RMD Open. 2021;7(3):e001882 (Nov 17). Doi: 10.1136/rmdopen-2021-001882.

Key clinical point: Patients with rheumatoid arthritis (RA) who are not obese, those who have high initial disease activity, and those with long disease duration are more responsive to tumor necrosis factor (TNF) inhibitors.

Major finding: The risk for European League Against Rheumatism nonresponse was significantly higher in patients with obesity vs. those with a body mass index of <30 kg/m² (odds ratio 0.52 vs. 0.36; P = .01). Among patients treated with TNF inhibitors, the final Disease Activity Score on 28 joints-C-reactive protein (DAS28-CRP) decreased by 0.02 each year of disease duration (P < .001), with a reduction of 0.21 in patients with a baseline DAS28-CRP of >5.1 (P = .05).

Study details: This was a pooled analysis of individual patient data of 11,617 patients with RA from 29 randomized controlled trials.

Disclosures: This work was partly supported by the French Higher Education and Research Ministry. P Goupille and D Mulleman declared serving as a consultant or speaker, participating in international congresses or clinical trials, and receiving grants from various sources.

Source: Law-Wan J et al. RMD Open. 2021;7(3):e001882 (Nov 17). Doi: 10.1136/rmdopen-2021-001882.

Key clinical point: Patients with rheumatoid arthritis (RA) who were treated with Janus kinase (JAK) inhibitor showed reduced humoral response following 2 doses of BNT162b2 COVID-19 vaccine compared with healthy individuals.

Major finding: Patients with RA treated with JAK inhibitors had significantly lower levels of anti-spike immunoglobulin G antibodies (P = .024) than healthy individuals.

Study details: This study involved 12 adult patients with RA treated with JAK inhibitors and 26 healthy individuals who received 2 doses of the BNT162b2 COVID-19 vaccine.

Disclosures: This work was funded by the ISF Corona grant. The authors declared no conflict of interests.

Source: Iancovici L et al. Rheumatology (Oxford). 2021:keab879 (Nov 25). Doi:  10.1093/rheumatology/keab879.

Key clinical point: Patients with rheumatoid arthritis (RA) who were treated with Janus kinase (JAK) inhibitor showed reduced humoral response following 2 doses of BNT162b2 COVID-19 vaccine compared with healthy individuals.

Major finding: Patients with RA treated with JAK inhibitors had significantly lower levels of anti-spike immunoglobulin G antibodies (P = .024) than healthy individuals.

Study details: This study involved 12 adult patients with RA treated with JAK inhibitors and 26 healthy individuals who received 2 doses of the BNT162b2 COVID-19 vaccine.

Disclosures: This work was funded by the ISF Corona grant. The authors declared no conflict of interests.

Source: Iancovici L et al. Rheumatology (Oxford). 2021:keab879 (Nov 25). Doi:  10.1093/rheumatology/keab879.

Key clinical point: Patients with rheumatoid arthritis (RA) who were treated with Janus kinase (JAK) inhibitor showed reduced humoral response following 2 doses of BNT162b2 COVID-19 vaccine compared with healthy individuals.

Major finding: Patients with RA treated with JAK inhibitors had significantly lower levels of anti-spike immunoglobulin G antibodies (P = .024) than healthy individuals.

Study details: This study involved 12 adult patients with RA treated with JAK inhibitors and 26 healthy individuals who received 2 doses of the BNT162b2 COVID-19 vaccine.

Disclosures: This work was funded by the ISF Corona grant. The authors declared no conflict of interests.

Source: Iancovici L et al. Rheumatology (Oxford). 2021:keab879 (Nov 25). Doi:  10.1093/rheumatology/keab879.

Key clinical point: Neutrophil count, white blood cell (WBC) count, or neutrophil-lymphocyte ratio (NLR) may help in ascertaining which patients hospitalized for community-acquired pneumonia (CAP) would benefit from adjunctive oral dexamethasone therapy.

Main finding: Among patients with a high neutrophil count, WBC count, or NLR who did not die in hospital, those who received dexamethasone had a shorter median length of stay (LOS) than those who received placebo (4 days vs. 6 days), whereas patients with low values for these parameters showed no difference in LOS between those receiving placebo and dexamethasone (P < .05).

Study details: Findings are from a post hoc analysis on 354 out of the 401 non-ICU patients with CAP included in the randomized placebo-controlled Santeon-CAP trial who were randomly assigned to receive either placebo or oral dexamethasone.

Disclosures: The study was sponsored by St. Antonius research fund. The authors declared no conflicts of interests.

Source: Wittermans E et al. Eur J Intern Med. 2021 (Nov 12). Doi: 10.1016/j.ejim.2021.10.030.

Key clinical point: Neutrophil count, white blood cell (WBC) count, or neutrophil-lymphocyte ratio (NLR) may help in ascertaining which patients hospitalized for community-acquired pneumonia (CAP) would benefit from adjunctive oral dexamethasone therapy.

Main finding: Among patients with a high neutrophil count, WBC count, or NLR who did not die in hospital, those who received dexamethasone had a shorter median length of stay (LOS) than those who received placebo (4 days vs. 6 days), whereas patients with low values for these parameters showed no difference in LOS between those receiving placebo and dexamethasone (P < .05).

Study details: Findings are from a post hoc analysis on 354 out of the 401 non-ICU patients with CAP included in the randomized placebo-controlled Santeon-CAP trial who were randomly assigned to receive either placebo or oral dexamethasone.

Disclosures: The study was sponsored by St. Antonius research fund. The authors declared no conflicts of interests.

Source: Wittermans E et al. Eur J Intern Med. 2021 (Nov 12). Doi: 10.1016/j.ejim.2021.10.030.

Key clinical point: Neutrophil count, white blood cell (WBC) count, or neutrophil-lymphocyte ratio (NLR) may help in ascertaining which patients hospitalized for community-acquired pneumonia (CAP) would benefit from adjunctive oral dexamethasone therapy.

Main finding: Among patients with a high neutrophil count, WBC count, or NLR who did not die in hospital, those who received dexamethasone had a shorter median length of stay (LOS) than those who received placebo (4 days vs. 6 days), whereas patients with low values for these parameters showed no difference in LOS between those receiving placebo and dexamethasone (P < .05).

Study details: Findings are from a post hoc analysis on 354 out of the 401 non-ICU patients with CAP included in the randomized placebo-controlled Santeon-CAP trial who were randomly assigned to receive either placebo or oral dexamethasone.

Disclosures: The study was sponsored by St. Antonius research fund. The authors declared no conflicts of interests.

Source: Wittermans E et al. Eur J Intern Med. 2021 (Nov 12). Doi: 10.1016/j.ejim.2021.10.030.

Key clinical point: Serum IL-17 levels show a positive correlation with the severity and poor prognostic outcomes in patients with community-acquired pneumonia (CAP).

Main finding: In patients with CAP, serum IL-17 levels at admission increased in parallel with CAP severity scores, such as pneumonia severity index, and, after adjusting for confounding factors, showed a positive correlation with intensive care unit (ICU) admission (adjusted odds ratio [aOR] 1.01; P = .01), mechanical ventilation (aOR 1.10; P = .02), death (aOR, 1.05; P < .01), and hospital stay of 14 days or more (aOR 1.21; P = .01).

Study details: This was a prospective cohort study including 239 patients who were hospitalized for CAP.

Disclosures: The National Natural Science Foundation of China, Anhui Provincial Natural Science Foundation, National Natural Science Foundation Incubation Program of the Second Affiliated Hospital of Anhui Medical University, and Scientific Research of Health Commission in Anhui Province sponsored the study. None of the authors declared any conflict of interests.

Source: Feng CM et al. BMC Pulm Med. 2021;21:393 (Dec 2). Doi: 10.1186/s12890-021-01770-6.

Key clinical point: Serum IL-17 levels show a positive correlation with the severity and poor prognostic outcomes in patients with community-acquired pneumonia (CAP).

Main finding: In patients with CAP, serum IL-17 levels at admission increased in parallel with CAP severity scores, such as pneumonia severity index, and, after adjusting for confounding factors, showed a positive correlation with intensive care unit (ICU) admission (adjusted odds ratio [aOR] 1.01; P = .01), mechanical ventilation (aOR 1.10; P = .02), death (aOR, 1.05; P < .01), and hospital stay of 14 days or more (aOR 1.21; P = .01).

Study details: This was a prospective cohort study including 239 patients who were hospitalized for CAP.

Disclosures: The National Natural Science Foundation of China, Anhui Provincial Natural Science Foundation, National Natural Science Foundation Incubation Program of the Second Affiliated Hospital of Anhui Medical University, and Scientific Research of Health Commission in Anhui Province sponsored the study. None of the authors declared any conflict of interests.

Source: Feng CM et al. BMC Pulm Med. 2021;21:393 (Dec 2). Doi: 10.1186/s12890-021-01770-6.

Key clinical point: Serum IL-17 levels show a positive correlation with the severity and poor prognostic outcomes in patients with community-acquired pneumonia (CAP).

Main finding: In patients with CAP, serum IL-17 levels at admission increased in parallel with CAP severity scores, such as pneumonia severity index, and, after adjusting for confounding factors, showed a positive correlation with intensive care unit (ICU) admission (adjusted odds ratio [aOR] 1.01; P = .01), mechanical ventilation (aOR 1.10; P = .02), death (aOR, 1.05; P < .01), and hospital stay of 14 days or more (aOR 1.21; P = .01).

Study details: This was a prospective cohort study including 239 patients who were hospitalized for CAP.

Disclosures: The National Natural Science Foundation of China, Anhui Provincial Natural Science Foundation, National Natural Science Foundation Incubation Program of the Second Affiliated Hospital of Anhui Medical University, and Scientific Research of Health Commission in Anhui Province sponsored the study. None of the authors declared any conflict of interests.

Source: Feng CM et al. BMC Pulm Med. 2021;21:393 (Dec 2). Doi: 10.1186/s12890-021-01770-6.

Key clinical point: In patients hospitalized for community-acquired pneumonia (CAP), the least risk of acute kidney injury (AKI) can be achieved by empiric treatment with a third-generation cephalosporin ± macrolide or a respiratory fluoroquinolone.

Main finding: Barring fluoroquinolones (adjusted odds ratio [aOR] 1.06; 95% CI 0.98-1.14), all regimens offered a higher risk for AKI than a third-generation cephalosporin ± macrolide, with piperacillin/tazobactam + vancomycin being associated with the highest AKI odds (aOR 1.89; 95% CI 1.73-2.06).

Study details: Findings are from a retrospective cohort study consisting of 449,535 adult patients hospitalized for CAP, of whom 3.1% developed AKI.

Disclosures: The study was sponsored by the Agency for Healthcare Research and Quality. The authors declared no conflict of interests.

Source: Le P et al. Curr Med Res Opin. 2021 (Nov 15). Doi: 10.1080/03007995.2021.2000716.

Key clinical point: In patients hospitalized for community-acquired pneumonia (CAP), the least risk of acute kidney injury (AKI) can be achieved by empiric treatment with a third-generation cephalosporin ± macrolide or a respiratory fluoroquinolone.

Main finding: Barring fluoroquinolones (adjusted odds ratio [aOR] 1.06; 95% CI 0.98-1.14), all regimens offered a higher risk for AKI than a third-generation cephalosporin ± macrolide, with piperacillin/tazobactam + vancomycin being associated with the highest AKI odds (aOR 1.89; 95% CI 1.73-2.06).

Study details: Findings are from a retrospective cohort study consisting of 449,535 adult patients hospitalized for CAP, of whom 3.1% developed AKI.

Disclosures: The study was sponsored by the Agency for Healthcare Research and Quality. The authors declared no conflict of interests.

Source: Le P et al. Curr Med Res Opin. 2021 (Nov 15). Doi: 10.1080/03007995.2021.2000716.

Key clinical point: In patients hospitalized for community-acquired pneumonia (CAP), the least risk of acute kidney injury (AKI) can be achieved by empiric treatment with a third-generation cephalosporin ± macrolide or a respiratory fluoroquinolone.

Main finding: Barring fluoroquinolones (adjusted odds ratio [aOR] 1.06; 95% CI 0.98-1.14), all regimens offered a higher risk for AKI than a third-generation cephalosporin ± macrolide, with piperacillin/tazobactam + vancomycin being associated with the highest AKI odds (aOR 1.89; 95% CI 1.73-2.06).

Study details: Findings are from a retrospective cohort study consisting of 449,535 adult patients hospitalized for CAP, of whom 3.1% developed AKI.

Disclosures: The study was sponsored by the Agency for Healthcare Research and Quality. The authors declared no conflict of interests.

Source: Le P et al. Curr Med Res Opin. 2021 (Nov 15). Doi: 10.1080/03007995.2021.2000716.

Key clinical point: Quick sequential (sepsis-related) organ failure assessment (qSOFA) is better than the Infectious Disease Society of America/American Thoracic Society minor criteria and worse than confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years (CURB-65) in predicting mortality in community-acquired pneumonia (CAP).

Main finding: The predictive validity of qSOFA for mortality (area under the receiver operating characteristic curve [AUROC] 0.868; 95% CI 0.853-0.882) was higher than that of minor criteria (AUROC 0.824; P < .0001) and lower than that of CURB-65 (AUROC 0.919; P < .0001).

Study details: The data come from an observational prospective cohort study consisting of 2,116 adult patients with CAP.

Disclosures: The study was sponsored by the Medical Science and Technology Foundation of Guangdong Province, Planned Science and Technology Project of Shenzhen Municipality, and Nonprofit Scientific Research Project of Futian District. The authors declared no conflict of interests.

Source: Guo Q et al. Am J Emerg Med. 2022(Feb);52:1-7 (Nov 24). Doi: 10.1016/j.ajem.2021.11.029.

Key clinical point: Quick sequential (sepsis-related) organ failure assessment (qSOFA) is better than the Infectious Disease Society of America/American Thoracic Society minor criteria and worse than confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years (CURB-65) in predicting mortality in community-acquired pneumonia (CAP).

Main finding: The predictive validity of qSOFA for mortality (area under the receiver operating characteristic curve [AUROC] 0.868; 95% CI 0.853-0.882) was higher than that of minor criteria (AUROC 0.824; P < .0001) and lower than that of CURB-65 (AUROC 0.919; P < .0001).

Study details: The data come from an observational prospective cohort study consisting of 2,116 adult patients with CAP.

Disclosures: The study was sponsored by the Medical Science and Technology Foundation of Guangdong Province, Planned Science and Technology Project of Shenzhen Municipality, and Nonprofit Scientific Research Project of Futian District. The authors declared no conflict of interests.

Source: Guo Q et al. Am J Emerg Med. 2022(Feb);52:1-7 (Nov 24). Doi: 10.1016/j.ajem.2021.11.029.

Key clinical point: Quick sequential (sepsis-related) organ failure assessment (qSOFA) is better than the Infectious Disease Society of America/American Thoracic Society minor criteria and worse than confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years (CURB-65) in predicting mortality in community-acquired pneumonia (CAP).

Main finding: The predictive validity of qSOFA for mortality (area under the receiver operating characteristic curve [AUROC] 0.868; 95% CI 0.853-0.882) was higher than that of minor criteria (AUROC 0.824; P < .0001) and lower than that of CURB-65 (AUROC 0.919; P < .0001).

Study details: The data come from an observational prospective cohort study consisting of 2,116 adult patients with CAP.

Disclosures: The study was sponsored by the Medical Science and Technology Foundation of Guangdong Province, Planned Science and Technology Project of Shenzhen Municipality, and Nonprofit Scientific Research Project of Futian District. The authors declared no conflict of interests.

Source: Guo Q et al. Am J Emerg Med. 2022(Feb);52:1-7 (Nov 24). Doi: 10.1016/j.ajem.2021.11.029.

Key clinical point: A positive association exists between blood glucose levels at hospital admission for community-acquired pneumonia (CAP) and 28-day mortality, and the strength of this association decreases with age.

Main finding: After adjusting for confounding factors, all patients exhibited a significant association between blood glucose levels at hospitalization and 28-day mortality (hazard ratio [HR] 2.08; P < .01). After age stratification, this association was evidenced in both middle-aged (HR 4.48; P < .01) and elderly (HR 1.52; P = .05) patients, but was stronger in the former (P = .01).

Study details: This was a retrospective observational study including 1,656 patients aged ≥45 years who were hospitalized for CAP, of which 592 were middle-aged (45-64 years) and 1,064 were elderly (>65 years).

Disclosures: The authors declared no conflict of interests.

Source: Shen Y et al. Int J Gen Med. 2021;14:7775-7781 (Nov 6). Doi: 10.2147/IJGM.S331082.

Key clinical point: A positive association exists between blood glucose levels at hospital admission for community-acquired pneumonia (CAP) and 28-day mortality, and the strength of this association decreases with age.

Main finding: After adjusting for confounding factors, all patients exhibited a significant association between blood glucose levels at hospitalization and 28-day mortality (hazard ratio [HR] 2.08; P < .01). After age stratification, this association was evidenced in both middle-aged (HR 4.48; P < .01) and elderly (HR 1.52; P = .05) patients, but was stronger in the former (P = .01).

Study details: This was a retrospective observational study including 1,656 patients aged ≥45 years who were hospitalized for CAP, of which 592 were middle-aged (45-64 years) and 1,064 were elderly (>65 years).

Disclosures: The authors declared no conflict of interests.

Source: Shen Y et al. Int J Gen Med. 2021;14:7775-7781 (Nov 6). Doi: 10.2147/IJGM.S331082.

Key clinical point: A positive association exists between blood glucose levels at hospital admission for community-acquired pneumonia (CAP) and 28-day mortality, and the strength of this association decreases with age.

Main finding: After adjusting for confounding factors, all patients exhibited a significant association between blood glucose levels at hospitalization and 28-day mortality (hazard ratio [HR] 2.08; P < .01). After age stratification, this association was evidenced in both middle-aged (HR 4.48; P < .01) and elderly (HR 1.52; P = .05) patients, but was stronger in the former (P = .01).

Study details: This was a retrospective observational study including 1,656 patients aged ≥45 years who were hospitalized for CAP, of which 592 were middle-aged (45-64 years) and 1,064 were elderly (>65 years).

Disclosures: The authors declared no conflict of interests.

Source: Shen Y et al. Int J Gen Med. 2021;14:7775-7781 (Nov 6). Doi: 10.2147/IJGM.S331082.

Key clinical point: Lefamulin is suitable as monotherapy against common community-acquired bacterial pneumonia (CABP)-causing pathogens, both typical and atypical, including drug-resistant strains and those causing polymicrobial infections.

Main finding: Lefamulin was as effective as moxifloxacin in the microbiological intent-to-treat (microITT) population, exhibiting a similar early clinical response rate (89.3% vs. 93.0%; difference ‒3.7; 95% CI ‒7.9 to 0.5) and investigator assessment of clinical response success rate (83.2% vs. 86.7%; difference ‒3.3; 95% CI ‒8.6 to 2.0).

Study details: The study analyzed pooled data from the phase 3 noninferiority Lefamulin Evaluation Against Pneumonia 1 and 2 trials, including a total of 1,289 adult patients with CABP (Pneumonia Outcomes Research Team risk classes II-V) who were randomly assigned to receive lefamulin or moxifloxacin. Of these, a baseline CABP pathogen was detected in 709 patients (microITT population).

Disclosures: Nabriva Therapeutics plc (Fort Washington, PA, USA) sponsored the study. Some of the authors, including the lead author, are former or current employees of or stockholders in Nabriva Therapeutics. A few others received research grants/consultation fees from various sources including Nabriva Therapeutics.

Source: Paukner S et al. J Glob Antimicrob Resist. 2021 (Nov 14). Doi: 10.1016/j.jgar.2021.10.021.

Key clinical point: Lefamulin is suitable as monotherapy against common community-acquired bacterial pneumonia (CABP)-causing pathogens, both typical and atypical, including drug-resistant strains and those causing polymicrobial infections.

Main finding: Lefamulin was as effective as moxifloxacin in the microbiological intent-to-treat (microITT) population, exhibiting a similar early clinical response rate (89.3% vs. 93.0%; difference ‒3.7; 95% CI ‒7.9 to 0.5) and investigator assessment of clinical response success rate (83.2% vs. 86.7%; difference ‒3.3; 95% CI ‒8.6 to 2.0).

Study details: The study analyzed pooled data from the phase 3 noninferiority Lefamulin Evaluation Against Pneumonia 1 and 2 trials, including a total of 1,289 adult patients with CABP (Pneumonia Outcomes Research Team risk classes II-V) who were randomly assigned to receive lefamulin or moxifloxacin. Of these, a baseline CABP pathogen was detected in 709 patients (microITT population).

Disclosures: Nabriva Therapeutics plc (Fort Washington, PA, USA) sponsored the study. Some of the authors, including the lead author, are former or current employees of or stockholders in Nabriva Therapeutics. A few others received research grants/consultation fees from various sources including Nabriva Therapeutics.

Source: Paukner S et al. J Glob Antimicrob Resist. 2021 (Nov 14). Doi: 10.1016/j.jgar.2021.10.021.

Key clinical point: Lefamulin is suitable as monotherapy against common community-acquired bacterial pneumonia (CABP)-causing pathogens, both typical and atypical, including drug-resistant strains and those causing polymicrobial infections.

Main finding: Lefamulin was as effective as moxifloxacin in the microbiological intent-to-treat (microITT) population, exhibiting a similar early clinical response rate (89.3% vs. 93.0%; difference ‒3.7; 95% CI ‒7.9 to 0.5) and investigator assessment of clinical response success rate (83.2% vs. 86.7%; difference ‒3.3; 95% CI ‒8.6 to 2.0).

Study details: The study analyzed pooled data from the phase 3 noninferiority Lefamulin Evaluation Against Pneumonia 1 and 2 trials, including a total of 1,289 adult patients with CABP (Pneumonia Outcomes Research Team risk classes II-V) who were randomly assigned to receive lefamulin or moxifloxacin. Of these, a baseline CABP pathogen was detected in 709 patients (microITT population).

Disclosures: Nabriva Therapeutics plc (Fort Washington, PA, USA) sponsored the study. Some of the authors, including the lead author, are former or current employees of or stockholders in Nabriva Therapeutics. A few others received research grants/consultation fees from various sources including Nabriva Therapeutics.

Source: Paukner S et al. J Glob Antimicrob Resist. 2021 (Nov 14). Doi: 10.1016/j.jgar.2021.10.021.

Key clinical point: Reinforcement of antibiotic stewardship by forming large multihospital collaboratives increases adherence to the appropriate 5-day therapy for uncomplicated community-acquired pneumonia (CAP) while decreasing adverse events.

Main finding: After adjusting for hospital clustering, the 20.9% predicted probability of patients receiving a 5-day antibiotic therapy increased to 45.9% (P < .001) over the study period, with the odds of this duration increasing (adjusted odds ratio [aOR] 1.10; 95% CI 1.07-1.14) and composite adverse events decreasing (aOR 0.98; 95% CI 0.96-0.99) with each successive quarter.

Study details: This study included 6,553 patients eligible for a 5-day therapy for uncomplicated CAP who were admitted to any of the 41 hospitals that participated in a state-wide collaborative quality initiative, Michigan Hospital Medicine Safety Consortium, for the entire 3-year study period.

Disclosures: The study was sponsored by Blue Cross Blue Shield of Michigan and a career development award from the Agency for Healthcare Research and Quality to the lead author who, along with other authors, also declared receiving salary, research grants, or speaker honoraria from additional sources.

Source: Vaughn VM et al. Clin Infect Dis. 2021:ciab950 (Nov 13). Doi: 10.1093/cid/ciab950.

Key clinical point: Reinforcement of antibiotic stewardship by forming large multihospital collaboratives increases adherence to the appropriate 5-day therapy for uncomplicated community-acquired pneumonia (CAP) while decreasing adverse events.

Main finding: After adjusting for hospital clustering, the 20.9% predicted probability of patients receiving a 5-day antibiotic therapy increased to 45.9% (P < .001) over the study period, with the odds of this duration increasing (adjusted odds ratio [aOR] 1.10; 95% CI 1.07-1.14) and composite adverse events decreasing (aOR 0.98; 95% CI 0.96-0.99) with each successive quarter.

Study details: This study included 6,553 patients eligible for a 5-day therapy for uncomplicated CAP who were admitted to any of the 41 hospitals that participated in a state-wide collaborative quality initiative, Michigan Hospital Medicine Safety Consortium, for the entire 3-year study period.

Disclosures: The study was sponsored by Blue Cross Blue Shield of Michigan and a career development award from the Agency for Healthcare Research and Quality to the lead author who, along with other authors, also declared receiving salary, research grants, or speaker honoraria from additional sources.

Source: Vaughn VM et al. Clin Infect Dis. 2021:ciab950 (Nov 13). Doi: 10.1093/cid/ciab950.

Key clinical point: Reinforcement of antibiotic stewardship by forming large multihospital collaboratives increases adherence to the appropriate 5-day therapy for uncomplicated community-acquired pneumonia (CAP) while decreasing adverse events.

Main finding: After adjusting for hospital clustering, the 20.9% predicted probability of patients receiving a 5-day antibiotic therapy increased to 45.9% (P < .001) over the study period, with the odds of this duration increasing (adjusted odds ratio [aOR] 1.10; 95% CI 1.07-1.14) and composite adverse events decreasing (aOR 0.98; 95% CI 0.96-0.99) with each successive quarter.

Study details: This study included 6,553 patients eligible for a 5-day therapy for uncomplicated CAP who were admitted to any of the 41 hospitals that participated in a state-wide collaborative quality initiative, Michigan Hospital Medicine Safety Consortium, for the entire 3-year study period.

Disclosures: The study was sponsored by Blue Cross Blue Shield of Michigan and a career development award from the Agency for Healthcare Research and Quality to the lead author who, along with other authors, also declared receiving salary, research grants, or speaker honoraria from additional sources.

Source: Vaughn VM et al. Clin Infect Dis. 2021:ciab950 (Nov 13). Doi: 10.1093/cid/ciab950.

Key clinical point: Patients with severe community-acquired pneumonia (SCAP) who also have type 2 diabetes mellitus (T2DM) have poorer clinical outcomes than those without T2DM.

Main finding: Compared with patients with SCAP but without T2DM, those with both exhibited higher rates of hospital mortality (35.2% vs. 31.0%; P = .009), 14-day mortality (15.0% vs. 10.8%; P < .001), 30-day mortality (25.7% vs. 22.7%; P = .046), and intensive care unit (ICU) mortality (30.8% vs. 26.5%; P = .005) along with a longer ICU length of stay (13 days vs. 12 days; P = .016).

Study details: Findings are from a retrospective, single-center, observational study including 3,786 adult patients admitted to an ICU for SCAP, among whom 1,262 patients with T2DM were matched to 2,524 patients without T2DM.

Disclosures: The study received funding from the National Natural Science Foundation of China, Science and Technology Department of Sichuan Province, and National Key Research and Development Program of China. The authors declared having no conflict of interests.

Source: Huang D et al. Crit Care. 2021;25:419 (Dec 7). Doi: 10.1186/s13054-021-03841-w.

Key clinical point: Patients with severe community-acquired pneumonia (SCAP) who also have type 2 diabetes mellitus (T2DM) have poorer clinical outcomes than those without T2DM.

Main finding: Compared with patients with SCAP but without T2DM, those with both exhibited higher rates of hospital mortality (35.2% vs. 31.0%; P = .009), 14-day mortality (15.0% vs. 10.8%; P < .001), 30-day mortality (25.7% vs. 22.7%; P = .046), and intensive care unit (ICU) mortality (30.8% vs. 26.5%; P = .005) along with a longer ICU length of stay (13 days vs. 12 days; P = .016).

Study details: Findings are from a retrospective, single-center, observational study including 3,786 adult patients admitted to an ICU for SCAP, among whom 1,262 patients with T2DM were matched to 2,524 patients without T2DM.

Disclosures: The study received funding from the National Natural Science Foundation of China, Science and Technology Department of Sichuan Province, and National Key Research and Development Program of China. The authors declared having no conflict of interests.

Source: Huang D et al. Crit Care. 2021;25:419 (Dec 7). Doi: 10.1186/s13054-021-03841-w.

Key clinical point: Patients with severe community-acquired pneumonia (SCAP) who also have type 2 diabetes mellitus (T2DM) have poorer clinical outcomes than those without T2DM.

Main finding: Compared with patients with SCAP but without T2DM, those with both exhibited higher rates of hospital mortality (35.2% vs. 31.0%; P = .009), 14-day mortality (15.0% vs. 10.8%; P < .001), 30-day mortality (25.7% vs. 22.7%; P = .046), and intensive care unit (ICU) mortality (30.8% vs. 26.5%; P = .005) along with a longer ICU length of stay (13 days vs. 12 days; P = .016).

Study details: Findings are from a retrospective, single-center, observational study including 3,786 adult patients admitted to an ICU for SCAP, among whom 1,262 patients with T2DM were matched to 2,524 patients without T2DM.

Disclosures: The study received funding from the National Natural Science Foundation of China, Science and Technology Department of Sichuan Province, and National Key Research and Development Program of China. The authors declared having no conflict of interests.

Source: Huang D et al. Crit Care. 2021;25:419 (Dec 7). Doi: 10.1186/s13054-021-03841-w.