Patients with community-acquired pneumonia (CAP) and treated with penicillin-G/V had less severe pneumonia than patients treated with broad-spectrum antibiotics or combination therapy, according to a new study conducted in Denmark.
The findings, “Penicillin Treatment for Patients With Community-Acquired Pneumonia In Denmark: A Retrospective Cohort Study,” were published in the journal BMC Pulmonary Medicine.
CAP is the most frequent lethal infection in Europe, but antibiotic treatment for patients differs among countries, both in type and duration.
According to researchers, as the diagnosis of the specific pathogen responsible for the infection may be difficult to obtain, the use of broad-spectrum antibiotics “is far more common than pathogen specific treatment.”
The objective of the study was to investigate the epidemiology of CAP in Denmark and evaluate the prognosis of patients treated with penicillin-G/V monotherapy. Penicillin G and V are first-generation penicillins that are widely used to treat pathogen infections.
Researchers analyzed data from 1,320 hospitalized patients with X-ray confirmed CAP and mild-to-moderate pneumonia to assess incidence, and the type and duration of antibiotic treatment.
Results showed that the incidence of hospitalized CAP patients was 3.1 per 1,000 individuals. The median age was 71 years and in-hospital mortality was 8%.
The median duration of antibiotic treatment was 10 days. Among the studied patients, nearly half (45%) received treatment with penicillin-G/V monotherapy. These patients had no higher mortality compared to those treated with broader-spectrum antibiotics, regardless of certain factors, such as age and other health conditions.
However, it is important to consider that patients on monotherapy penicillin G/V were less sick, which may bias the interpretation of the results. “Because penicillin monotherapy was given to patients with mild disease, mortality is expected to be low independently of the treatment and we cannot conclude whether mortality would have been lower if broad spectrum antibiotic or combination therapy were given,” the researchers wrote.
The study also showed that the duration of treatment exceeded recommendations in European guidelines, which recommend five to seven days of antibiotic treatment.
“It is important to ensure compliance with guidelines concerning treatment duration and validation of strategies to reduce duration of treatment in order to minimize unnecessary side-effects,” the team wrote. “Prospective, randomized control trials would be necessary to confirm whether empiric monotherapy with penicillin-G/V is recommendable.”