Amoxicillin/clavulanate activity against bacteria isolated in severe community-acquired pneumonia: a retrospective study (sCAP)

IF 2.2 4区医学 Q2 INFECTIOUS DISEASES

Infectious diseases now Pub Date : 2025-07-25 DOI:10.1016/j.idnow.2025.105122

A. Sarr , M.A. Matta , F. Kayembe , A. Depontfarcy , M. Monchi , S. Diamantis

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Abstract

Background

Severe community-acquired pneumonia (sCAP) requires prompt empirical antibiotic therapy. Amoxicillin-clavulanate (AMC), an “Access” antibiotic per WHO AWaRe classification, could possibly constitute an ecologically preferable alternative to third-generation cephalosporins (3GCs).

Objectives

To assess AMC susceptibility in bacterial isolates from sCAP patients and to identify factors associated with AMC resistance.

Methods

A retrospective single-center study was conducted between 2019 and 2021 in a single ICU. Patients with sCAP and positive respiratory cultures within 48 h were included.

Results

In 185 patients, 212 isolates were identified. AMC susceptibility was 83.5 % overall, with the highest rates for S. pneumoniae (97.9 %), H. influenzae (84.6 %), and S. aureus (96.1 %). Prior antibiotic use within three months was the only independent factor associated with AMC resistance (p < 0.00001). Susceptibility reached 90.9 % in patients without prior antibiotic use.

Conclusion

AMC is a viable empirical option for sCAP treatment in patients without recent antibiotic exposure, offering more pronounced ecological benefits than 3GCs.

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阿莫西林/克拉维酸对严重社区获得性肺炎分离细菌的活性：回顾性研究（sCAP）

背景：严重社区获得性肺炎（sCAP）需要及时的经验性抗生素治疗。阿莫西林-克拉维酸（AMC）是世卫组织AWaRe分类中的一种“可获得”抗生素，在生态上可能是第三代头孢菌素（3gc）的更好替代品。目的评估sCAP患者分离的细菌对AMC的敏感性，并确定AMC耐药的相关因素。方法于2019 - 2021年在单个ICU进行回顾性单中心研究。纳入48 h内sCAP和呼吸培养阳性的患者。结果185例患者共分离出212株。AMC的总体易感性为83.5%，其中肺炎链球菌（97.9%）、流感嗜血杆菌（84.6%）和金黄色葡萄球菌（96.1%）的易感性最高。既往3个月内使用抗生素是与AMC耐药相关的唯一独立因素(p <；0.00001)。未使用过抗生素的患者对抗生素的敏感性达到90.9%。结论对于近期无抗生素暴露的sCAP患者，amc是一种可行的经验选择，具有比3gc更明显的生态效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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