Amoxicillin/clavulanate activity against bacteria isolated in severe community-acquired pneumonia: a retrospective study (sCAP) - 01/11/25
, M.A. Matta a, F. Kayembe a, A. Depontfarcy a, M. Monchi c, S. Diamantis a, bHighlights |
• | AMC showed 90.9% bacterial sensitivity in severe CAP patients without recent antibiotic use, supporting its empirical use. |
• | Recent antibiotic exposure (≤3 months) was the sole predictor of AMC resistance (54.5%), guiding tailored treatment. |
• | Classified as "Access" (WHO AWaRe), AMC poses a lower resistance risk than "Watch" drugs like cephalosporins. |
• | AMC susceptibility (83.5%) was close to cephalosporins (89.6%) but lower than piperacillin/tazobactam (95.8%), reserved for high-risk cases. |
• | Combine AMC with macrolides for sCAP; reserve piperacillin/tazobactam for patients with recent antibiotic use. |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Severe community acquired pneumonia, Amoxicillin/clavulanate, Cephalosporin, AWaRe
Plan
Vol 55 - N° 7
Article 105122- novembre 2025 Retour au numéro
Article précédent
- Rapid-sequence clinical research before and during a pandemic: Lessons learned and the way forward
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