To evaluate in routine hospital practice the clinical response to
ertapenem in comparison with other parenteral
antibiotics in the treatment of community-acquired
pneumonia (CAP), clinical records from patients with severe CAP treated with
ertapenem from July 2002 to June 2006 in seven Spanish hospitals were retrospectively reviewed. Patients were classified according to the
Pneumonia Severity Index (PSI). Each
ertapenem-treated patient was matched with two patients in the same hospital treated with other
antibiotics, according to age (difference <or=5 years), same PSI class and whether or not resident in a
nursing home. Seventy-one patients treated with
ertapenem and 131 matched controls were identified; 71 of the 202 patients came from nursing homes. A larger (p 0.0002) number of patients were treated with monotherapy in the
ertapenem group. In total, 174 patients (86.1%) belonged to PSI classes IV-V; a higher (p <0.0001) PSI score was found in patients from nursing homes. The mean age was 80.5 years (75% of patients >76 years). Comorbidities were present in 193 patients (95.5%). No differences were found in median
hospital stay (7 days for
ertapenem vs. 10 days for comparators, p 0.066). A slightly higher clinical response rate was obtained for
ertapenem vs. comparators (88.7% vs. 77.1%; p 0.0465; OR 2.25; 95% CI 0.99-5.12), with significant differences in clinical response in patients coming from nursing homes (95.8%
ertapenem vs. 63.8% comparators; p 0.0034) but not in non-institutionalized patients (85.4%
ertapenem vs. 84.5% comparators; p 0.929). The higher clinical response to
ertapenem vs. comparators in severe CAP was due to its significantly higher efficacy in healthcare-associated CAP in patients coming from nursing homes.