caa a22 4500 477071007 CHVBK 20180405111425.0 cr unu---uuuuu 170330e19960401xx s 000 0 eng 10.1007/BF01695659 doi (NATIONALLICENCE)springer-10.1007/BF01695659 Delay in appropriate therapy of Legionella pneumonia associated with increased mortality [Elektronische Daten] [C. Heath, D. Grove, D. Looke] The prognostic significance of delayed therapy in Legionnaires' disease is poorly defined. Thirty-nine consecutive serologically confirmed cases of Legionnaires' disease were reviewed to examine whether an association exists between delayed therapy and prognosis. Clinical and laboratory factors predictive of mortality were also sought. Thirty-one cases (79%) were classified as having severe pneumonia at diagnosis. Thirty-six patients (92%) had community-acquired infection, and three patients (8%) had nosocomial disease. Ten patients died, resulting in a crude mortality rate of 26%. At the first assessment, variables noted for pneumonia associated with death were low diastolic blood pressure (p < 0.02), low serum albumin concentration (p < 0.04), and increased number of days from onset of pneumonia to hospitalisation (prodrome) (p < 0.02). However, multiple logistic regression analysis revealed that the prodrome was the only variable noted at diagnosis that achieved significance (p = 0.024). Mortality also correlated with both delay in the initiation of erythromycin therapy following admission (p < 0.001) and the total delay in starting erythromycin therapy (p < 0.001). It is therefore recommended that erythromycin be included early in the empiric therapy of severe community-acquired pneumonia. Springer-Verlag, 1996 Heath C. Department of Clinical Microbiology and Infectious Diseases, The Queen Elizabeth Hospital, Woodville Road, 5011, Woodville, South Australia, Australia aut Grove D. Department of Clinical Microbiology and Infectious Diseases, The Queen Elizabeth Hospital, Woodville Road, 5011, Woodville, South Australia, Australia aut Looke D. Department of Clinical Microbiology and Infectious Diseases, The Queen Elizabeth Hospital, Woodville Road, 5011, Woodville, South Australia, Australia aut European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/4(1996-04-01), 286-290 0934-9723 15:4<286 1996 15 10096 https://doi.org/10.1007/BF01695659 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01695659 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Heath C. Department of Clinical Microbiology and Infectious Diseases, The Queen Elizabeth Hospital, Woodville Road, 5011, Woodville, South Australia, Australia aut NATIONALLICENCE 700 1- Grove D. Department of Clinical Microbiology and Infectious Diseases, The Queen Elizabeth Hospital, Woodville Road, 5011, Woodville, South Australia, Australia aut NATIONALLICENCE 700 1- Looke D. Department of Clinical Microbiology and Infectious Diseases, The Queen Elizabeth Hospital, Woodville Road, 5011, Woodville, South Australia, Australia aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/4(1996-04-01), 286-290 0934-9723 15:4<286 1996 15 10096 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer