Resolution of symptoms in patients with community-acquired pneumonia treated on an ambulatory basis

J Infect. 2004 Nov;49(4):302-9. doi: 10.1016/j.jinf.2003.11.013.

Abstract

Objective: To describe the resolution of five symptoms commonly associated with community-acquired pneumonia (CAP).

Methods: Three hundred and ninety-nine patients with CAP (Fine Classes I to III) recorded the severity (from 0 to 5) of fatigue, cough, dyspnoea, sputum, and pleuritic chest pain daily from enrollment to day 14 and also on days 30 and 42. A total symptom score was obtained by multiplying an individual score by four and summing the score of the five symptom (transformed score). A total symptom score of <or= 20 or an individual symptom untransformed score of <or= 1 was defined as resolution.

Results: The mean untransformed symptom scores at the time of presentation were: fatigue (3.5 +/- 1.4), cough (3.5 +/- 1.5), dyspnoea (2.7 +/- 1.5), sputum production (2.2 +/- 1.6) and chest pain (2.1 +/- 1.7). Sixty-seven percent had resolution of symptoms by day 14. When the study population was divided according to a mean total symptom score of <or= 20 or > 20 on day 14, the patients with a score > 20 (n = 122; 33%) had higher symptom scores at all time points out to 42 days. The median time to return to work was 6 days.

Conclusion: The pneumonia symptom severity score is a useful tool for advising patients regarding the time to symptomatic resolution of pneumonia.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ambulatory Care*
  • Anti-Bacterial Agents / therapeutic use*
  • Aza Compounds / therapeutic use*
  • Clarithromycin / therapeutic use*
  • Community-Acquired Infections / drug therapy*
  • Community-Acquired Infections / physiopathology
  • Double-Blind Method
  • Female
  • Fluoroquinolones
  • Humans
  • Male
  • Middle Aged
  • Moxifloxacin
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / physiopathology
  • Prospective Studies
  • Quinolines / therapeutic use*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Clarithromycin
  • Moxifloxacin