Aspiration pneumonia
Conditions
Interventions
cefepime 1g dose parenteral infusion, every 8 hrs, for 4-14 days. May be adjusted when renal failure. Erythromycin 500mg parenteral infusion every 12 hrs, or Azithromycin 500mg parenteral infusion e
Sponsors
Ono Municipal Hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: (1)Hospital-admitted patients aged 15 yrs or more with a diagnosis of moderate to severe pneumonia and required initial parenteral treatment. (2)At least one of the following conditions of risk for aspiration pneumonia: neurological disorders (cerebrovascular diseases, neuromuscular diseases, dementia, etc.), bed-ridden, oral/pharyngeal/laryngeal disorder, gastro-esophageal disorder (esophageal diverticulum, achalasia, systemic sclerosis, esophageal cancer, GERD, post-gastrectomy (total or partial), hiatal hernia, etc.), usage of sedatives or hypnotics, insertion of a nasogastric tube, subjective or observed aspiration/choking/dysphagia, episode of vomiting. (3)Radiological appearance of a new and/or progressive pulmonary infiltrate(s) (4) At least two of the followings: cough, sputum or change of sputum character (increased volume and/or purulence), dyspnea, tachypnea, abnormal breathing sound (wheeze etc.), pleuritic chest pain, auscultatory findings on chest examination consistent with the lung infiltrate, documented body temperature > or = 37.5C within the past 24hrs, rigors and/or chills, general malaise, and a WBC count of > or = 10,000/mm3 or < 3,000/mm3.
Exclusion criteria
Exclusion criteria: (1) Hospital-acquired pneumonia (2) Hospitalization within 60 days prior to the development of the symptom(s) (3) Immunocompromising disease or receipt of immunopompromising therapy (4) Active lung cancer (5) Terminal illness (6) Pregnancy or breast-feeding (7) Known allergy to the indicated antibiotics (8) Other infiltrative diseases (e.g. radiation pneumonitis, organizing pneumonia, drug-induced pneumonia, obstructive pneumonia etc.) (9) Tuberculosis, fungal infection (10) Empyema
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Clinical response at the end of therapy, days 11-14 | — |
Secondary
| Measure | Time frame |
|---|---|
| Early clinical response at days 4 and 7 Bacteriological response at days 11-14 (in bacteriologically evaluable patients) Survival at day 30 | — |
Countries
Japan
Contacts
Public ContactSeizo Kadowaki
Ono Municipal Hospital Department of Internal Medicine
Outcome results
None listed