The aim of this study was to compare the evolution of systemic
cytokine levels over time in patients with pneumococal
pneumonia treated either with β-
lactam monotherapy or with combination
therapy (β-
lactam plus
fluoroquinolone). Prospective observational study of hospitalized non-immunocompromised adults with PP. Concentrations of
IL-6,
IL-8,
IL-10, and TNF-α were determined on days 0, 1, 2, 3, 5, and 7. Patients on β-
lactam monotherapy were compared with those receiving combination
therapy. Fifty-two patients were enrolled in the study. Concentrations of
IL-6,
IL-8, and
IL-10 decreased rapidly in the first days after admission, in accordance with the mean time to defervescence. High levels of
IL-6 were found in patients with the worst outcomes, measured by the need for intensive care unit admission and mortality. No major differences in demographic or clinical characteristics or severity of disease were found between patients treated with β-
lactam monotherapy and those treated with combination
therapy.
IL-6 levels fell more rapidly in patients with combination
therapy in the first 48 h (p = 0.016). Our data suggest that systemic expression of
IL-6 production in patients with PP correlates with prognosis. Initial combination
antibiotic therapy produces a faster decrease in this
cytokine in the first 48 h.