Silvia Terraneo1, Eva Polverino2, Catia Cilloniz2, Rosanel Amaro2, M del Carmen Vennera2, Albert Gabarrus2, Beatriz Montull3, Encarnación Moreno2, Rosario Menendez3, Stefano Centanni4, Antoni Torres5. 1. Respiratory Unit, San Paolo Hospital, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy; Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain. 2. Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain. 3. Department of Pneumology, Hospital La Fe Valencia, Ciber de Enfermedades Respiratorias (CIBERES), Spain. 4. Respiratory Unit, San Paolo Hospital, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy. 5. Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, SGR 911, Ciber de Enfermedades Respiratorias (CIBERES), Spain. Electronic address: atorres@clinic.ub.es.
Abstract
BACKGROUND: Limited information is available about clinical outcomes and microbiology of community-acquired pneumonia in asthma. METHODS: We prospectively studied 4079 CAP patients over a 12-years period and found 139 (3.4%) asthmatic patients. RESULTS: Asthmatics showed younger age (57 ± 19 vs. 66 ± 19 years), less males (32% vs. 68%) and less active smokers (15% vs. 25%). Moreover, they had used more frequently inhaled corticosteroids (ICs, 53% vs. 17%, p < 0.001) and antibiotics (32% vs. 24%, p = 0.041). In comparison with non asthma-CAP, asthmatics showed at admission more pleuritic pain and dyspnoea but less severe pneumonia (PSI, CURB-65, PaO(2)/FIO(2) ratio; p < 0.05). No differences were observed in CAP microbiology, being Streptococcus pneumoniae the most frequent isolate. Clinical outcomes in asthmatic patients were similar to the general population (mortality, mechanical ventilation, etc.) but with a shorter median length of stay (6 [3; 9] vs. 7 [4; 10] days, p = 0.023). The chronic use of ICs did not influence clinical presentation and outcomes among asthmatic patients. CONCLUSIONS: Asthmatics were younger and showed similar clinical presentation. Consistently with PSI, asthmatics showed similar outcomes than the general population. The microbial aetiology of CAP in asthma did not differ from the general population and antibiotic therapy should follow current guidelines.
BACKGROUND: Limited information is available about clinical outcomes and microbiology of community-acquired pneumonia in asthma. METHODS: We prospectively studied 4079 CAP patients over a 12-years period and found 139 (3.4%) asthmatic patients. RESULTS: Asthmatics showed younger age (57 ± 19 vs. 66 ± 19 years), less males (32% vs. 68%) and less active smokers (15% vs. 25%). Moreover, they had used more frequently inhaled corticosteroids (ICs, 53% vs. 17%, p < 0.001) and antibiotics (32% vs. 24%, p = 0.041). In comparison with non asthma-CAP, asthmatics showed at admission more pleuritic pain and dyspnoea but less severe pneumonia (PSI, CURB-65, PaO(2)/FIO(2) ratio; p < 0.05). No differences were observed in CAP microbiology, being Streptococcus pneumoniae the most frequent isolate. Clinical outcomes in asthmatic patients were similar to the general population (mortality, mechanical ventilation, etc.) but with a shorter median length of stay (6 [3; 9] vs. 7 [4; 10] days, p = 0.023). The chronic use of ICs did not influence clinical presentation and outcomes among asthmatic patients. CONCLUSIONS: Asthmatics were younger and showed similar clinical presentation. Consistently with PSI, asthmatics showed similar outcomes than the general population. The microbial aetiology of CAP in asthma did not differ from the general population and antibiotic therapy should follow current guidelines.
Authors: Ping-Kun Tsai; Shih-Ming Tsao; Wei-En Yang; Chao-Bin Yeh; Hsiang-Ling Wang; Shun-Fa Yang Journal: Int J Environ Res Public Health Date: 2019-03-21 Impact factor: 3.390