Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia

Am J Respir Crit Care Med. 2004 Aug 15;170(4):440-4. doi: 10.1164/rccm.200311-1578OC. Epub 2004 Jun 7.


Retrospective studies have suggested that combination antibiotic therapy for severe bacteremic pneumococcal pneumonia may reduce mortality. We assessed this issue in a prospective, multicenter, international observational study of 844 adult patients with bacteremia due to Streptococcus pneumoniae. The effect of combination antibiotic therapy versus monotherapy on mortality was examined by univariate analyses and by logistic regression models. The 14-day mortality was not significantly different for the two groups. However, among critically ill patients, combination antibiotic therapy was associated with lower 14-day mortality (23.4 versus 55.3%, p = 0.0015). This improvement in survival was independent of country of origin, intensive care unit support, class of antibiotics, or in vitro activity of the antibiotics prescribed. Combination antibiotic therapy improved survival among critically ill patients with bacteremic pneumococcal illness.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents*
  • Bacteremia / drug therapy*
  • Bacteremia / mortality*
  • Critical Care / methods
  • Critical Illness
  • Drug Therapy, Combination / therapeutic use*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Pneumococcal Infections / drug therapy*
  • Pneumococcal Infections / mortality*
  • Prospective Studies
  • Survival Analysis


  • Anti-Bacterial Agents