Impact of positive legionella urinary antigen test on patient management and improvement of antibiotic use. Issue 12 (24th November 2004)

• Record Type: Journal Article
• Authors: Garbino, J; Bornand, J-E; Uçkay, I; Fonseca, S; Sax, H
• Is Part Of: Journal of clinical pathology. Volume 57:Issue 12(2004)
• Page Start: 1302
• Page End: 1305
• Publication Date: 2004-11-24
• Subjects: legionella urinary antigen test -- antibiotic use -- cost reduction -- Legionella pneumophila -- macrolides; Pathology -- Periodicals; Pathology, Molecular -- Periodicals; 616.0705
• DOI: 10.1136/jcp.2004.018861
• Languages: English
• ISSNs: 0021-9746

Abstract

Abstract : Aim: To assess the incidence of legionella infection over a 27 month period at a large university hospital. Material and Methods: The present retrospective cohort study enrolled patients with legionellosis, defined as those presenting a positive urinary antigen for legionella together with a medical history, clinical findings, and radiological findings consistent with pneumonia. These patients were evaluated to determine the relation between their test results and changes in treatment modalities. A control group of patients with pneumonia but a negative urinary antigen test for legionella were also analysed. Results: Twenty seven of 792 assessed patients tested positive for legionella. In 22 of these patients, legionella active antibiotics were administered empirically. In seven patients, the test results prompted a legionella specific treatment, whereas in 12 cases, non-specific antibiotics were stopped within 24 hours. Overall, treatment was altered in more than half of the patients as a result of the test results. Conclusions: The urinary antigen may have a direct impact on clinical management of pulmonary legionellosis. However, patient comorbidities and individual clinical judgment are still important for determining the best treatment to be given in each individual case.