Garnacho-Montero, JoséGarcía-Cabrera, EmilioDiaz-Martín, AnaLepe, José AntonioIraurgi-Arcarazo, PatriciaJiménez-Alvarez, RocioRevuelto-Rey, JaumeAznar, Javier2025-01-282025-01-282009-10-14Garnacho-Montero J, García-Cabrera E, Diaz-Martín A, Lepe-Jiménez JA, Iraurgi-Arcarazo P, Jiménez-Alvarez R et al. Determinants of outcome in patients with bacteraemic pneumococcal pneumonia: importance of early adequate treatment. Scand J Infect Dis. 2010 Mar;42(3):185-92.0036-5548https://hdl.handle.net/10668/28456We set out to determine the factors influencing mortality in 125 adult patients with bacteraemic pneumococcal community-acquired pneumonia (CAP), assessing the impact on outcomes of early adequate therapy in particular. Presumed prognostic factors with p < 0.1 in the unadjusted model were subjected to multivariate Cox regression analysis, with in-hospital and 90-day mortalities as the dependent variables. A time period of >4 h from admission to start of adequate antibiotic treatment (adjusted hazard ratio (aHR) 2.62, 95% confidence interval (CI) 1.06-6.45; p =0.037) and severe sepsis or septic shock (aHR 5.06, 95% CI 1.63-15.71; p = 0.005) were independently associated with in-hospital mortality. Variables associated with 90-day mortality were Charlson comorbidity index (aHR 1.17, 95% CI 1.02-1.34; p = 0.018), severe sepsis or septic shock (aHR 3.03, 95% CI 1.22-7.51; p = 0.016) and delay of adequate antibiotic therapy >4 h (aHR 2.21, 95% CI 1.01-4.86; p = 0.048). The use of combination therapy was not included in these models but was a protective factor for delayed adequate therapy (aHR 0.53, 95% CI 0.29-0.95; p = 0.033). Administration of adequate antimicrobial therapy within 4 h of arrival is a critical determinant of survival in patients with bacteraemic pneumococcal CAP.enBacteraemic pneumococcal pneumoniaCommunity-acquired pneumonia (CAP)Adequate antimicrobial therapySevere sepsisMultivariate Cox regression analysisPneumonia, PneumococcalSepsisAnti-Bacterial AgentsCommunity-Acquired InfectionsMortalityresearch article20085422restricted accessNeumonía NeumocócicaSepsisAgentes antibacterianosInfecciones Comunitarias AdquiridasMortalidad10.3109/003655409034185221651-1980