To investigate the relationship of efficacy of
chemotherapy to host defense, we reviewed the clinical features, treatment and outcome in 648 patients with acute
pneumonia (424 males and 224 females; mean age, 65 years) treated between 1984 and 1989.
Pneumonia complicated
pulmonary disease in 336 patients (52%) and complicated systemic disease in 258 (40%).
Pneumonia pathogens were diagnosed in 346 patients (53%); the five major pathogens were S. pneumoniae (19%), H. influenzae (16%), S. aureus (14%), K. pneumoniae (14%) and P. aeruginosa (11%). The incidence of K. pneumoniae
infection were decreased from 18% to 3.5% and that of S. aureus increased from 10.9% to 26.3% during the study period. The incidence of S. aureus and of P. aeruginosa
infection was much higher in patients with
nosocomial pneumonia, systemic disease, or
serum protein concentration under 6.5 g/dl.
beta-lactamase antibiotics were administered to 70% of all patients, with an efficacy rate of 74.9% of after the first course of
antibiotics therapy. The efficacy rate was decreased in patients with
nosocomial pneumonia, systemic or
pulmonary disease, or
malnutrition. The data presented in this study indicate that the risk of
pneumonia must be taken into careful consideration in patients with compromising complications.