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August 7, 1995

High Alcohol Intake as a Risk and Prognostic Factor for Community-Acquired Pneumonia

Author Affiliations

From the Alcohol Research (Drs Fernández-Solá, Junqué, Estruch, Monforte, and Urbano-Márquez) and Pneumology (Dr Torres) Units, Department of Internal Medicine, Hospital Clinic, University of Barcelona (Spain).

Arch Intern Med. 1995;155(15):1649-1654. doi:10.1001/archinte.1995.00430150137014

Objective:  To evaluate whether high alcohol intake is an independent risk factor for community-acquired pneumonia in middle-aged people and whether it confers a poor prognosis.

Methods:  A two-phase study was performed. Risk factors for community-acquired pneumonia were evaluated in a case-control study of 50 patients and 50 controls. Prognostic factors and microbiologic and clinical features were then evaluated in a cohort study of the 50 middle-aged patients with community-acquired pneu

Results:  In the first study, the only independent risk factor for community-acquired pneumonia was high alcohol intake (P<.02). In the second study, patients with chronic alcoholism had a higher incidence of pneumonia caused by gram-negative bacilli (P<.03), as well as a higher incidence of Candida albicans (P<.03), Staphylococcus aureus (P<.0001), and gram-negative bacilli (P<.001) in the cultures of pharyngeal smears than did the nonalcoholics. Compared with nonalcoholic patients, alcoholic patients with pneumonia showed more severe clinical symptoms (P<.02), required longer intravenous treatment (P<.02) and longer hospital stay (P<.01), and had multilobar involvement and pleural effusion (both P<.01), as well as slower resolution of pulmonary infiltrates. The only prognostic factor for mortality was high alcohol intake (P<.03).

Conclusions:  High alcohol intake is the main risk factor for developing community-acquired pneumonia in middle-aged people. This situation also confers a worse prognosis in these patients, who should be treated with broad-spectrum antibiotics for a longer period.(Arch Intern Med. 1995;155:1649-1654)

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