Usefulness of gram-stained sputum obtained just after administration of antimicrobial agents as the earliest therapeutic indicator for evaluating the effectiveness of empiric therapy in community-acquired pneumonia caused by pneumococcus or Moraxella catarrhalis

The efficacy of high-dose penicillin G for pneumococcal pneumonia diagnosed based on initial comprehensive assessment at admission: an observational study

Objectives

High-dose penicillin therapy is effective in approximately 90% of pneumococcal pneumonia cases diagnosed based on urinary pneumococcal antigen tests or Gram staining at admission. The efficacy of high-dose penicillin therapy for pneumococcal pneumonia diagnosed based on an initial comprehensive assessment comprising a syndromic approach, Gram staining of sputum and urinary pneumococcal antigen testing was investigated.

Results

Seventy adult patients diagnosed with pneumococcal pneumonia based on an initial comprehensive assessment and treated with high-dose penicillin G at admission were included. The median patient age was 76.5 years, and 37.1% of the patients were women. The urinary pneumococcal antigen test was positive in 67.1% of all patients, and Gram staining of sputum showed that gram-positive cocci were dominant in 58.6% of the patients. The primary outcome was treatment success based on vital signs until day 6. Treatment with high-dose penicillin G was effective in 87.1% of the patients (95% CI 79.1–95.2%), and the proportion of patients who received other antibiotics because of treatment failure with penicillin G was only 5.7%. The efficacy of high-dose penicillin G treatment for pneumococcal pneumonia diagnosed based on a comprehensive assessment at admission may be comparable to that in previous reports.

Electronic supplementary material

The online version of this article (10.1186/s13104-018-3510-7) contains supplementary material, which is available to authorized users.

Serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae isolates from adult patients in Jakarta, Indonesia

Currently, the data on pneumococcal invasive disease in the Indonesian population are limited. In this study, we investigated the serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae. These samples were isolated from the sputum of adult patients with non-specific clinical symptoms aged 18-87 years in Jakarta, Indonesia, from August to October 2014. Of the 349 sputum specimens, thirteen isolates were identified as S. pneumoniae strains (4%), with two strains each for serotype 19F, 3, and 15A, and one strain each for serotype/serogroup 13, 23A, 6, 34, 17F, 16F, and untypeable. Resistance to tetracycline was most common with only 5 of 13 strains being susceptible. In conclusion, these data provide an initial in the surveillance of invasive pneumococcus in the Indonesia population.