Pneumonia: Improved Antibiotic Strategies and Decreased Mortality Interview with:
Dr Simone Gattarello
Vall d’Hebron Hospital, Critical Care Department
Universitat Autonoma de Barcelona and Medicine Department, Spain What are the main findings of the study?

Dr. Gattarello: The main findings from the present study are a 15% decrease in ICU mortality due to severe community-acquired pneumonia caused by Streptococcus pneumoniae in the last decade; moreover, several changes in antibiotic prescription practices were detected and an association between improved survival and both earlier antibiotic administration and increased combined antibiotic therapy were identified. In summary, in severe pneumococcal pneumonia combined antibiotic therapy and early antibiotic administration are associated with lower mortality. Were any of the findings unexpected?

Dr. Gattarello: In the last years various studies were published about infection and mortality, but, the majority of them were realized in the whole population without differentiation between mild infection versus sepsis or sepsis shock. The majority of those previous studies didn’t find a decrease in mortality. Otherwise, in the present study, where only patients with severe sepsis and septic shock due to pneumonia were included, we discover a significant decrease of mortality. In that way, our results were unexpected. What should clinicians and patients take away from your report?

Dr. Gattarello: In the last decade, ICU mortality due to severe pneumococcal pneumonia has significantly decreased; an improved survival was associated with earlier antibiotic prescription and an increased use of combined antibiotic therapy. What recommendations do you have for future research as a result of this study?

Dr. Gattarello: It would be interesting to investigate if the use of different antibiotic regimens or doses are associated with lower mortality.


Gattarello S, Borgatta B, Solé-Violán J, et al.

Decrease in mortality in severe community-acquired pneumococcal pneumonia: impact of improving antibiotic strategies (2000-2013)

Published online December 26, 2013.