ORIGINAL ARTICLE RESPIRATORY INFECTIONS Broad-spectrum antibiotic use and poor outcomes in community-onset pneumonia: a cohort study Brandon J. Webb1,2, Jeff Sorensen3, Al Jephson3, Ian Mecham4 and Nathan C. Dean3,5 Affiliations: 1Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, UT, USA. 2Division of Infectious Diseases and Geographic Medicine, Stanford University, Palo Alto, CA, USA. 3Division of Pulmonary and Critical Care Medicine, Intermountain Healthcare, Salt Lake City, UT, USA. 4Division of Pulmonary and Critical Care, Utah Valley Regional Medical Center, Intermountain Healthcare, Provo, UT, USA. 5Division of Pulmonary Medicine, University of Utah, Salt Lake City, UT, USA. Correspondence: Brandon J. Webb, Division of Infectious Diseases and Clinical Epidemiology, Intermountain Medical Center, 5121 South Cottonwood Drive, Murray, UT 84157, USA. E-mail:
[email protected] @ERSpublications Despite propensity-based, weighted balancing including providers and adjustment for multiple patient-level confounders, broad-spectrum antibiotics appear to be associated with increased mortality and other poor outcomes in community-onset pneumonia http://bit.ly/2DafBax Cite this article as: Webb BJ, Sorensen J, Jephson A, et al. Broad-spectrum antibiotic use and poor outcomes in community-onset pneumonia: a cohort study. Eur Respir J 2019; 54: 1900057 [https://doi.org/ 10.1183/13993003.00057-2019]. ABSTRACT Question: Is broad-spectrum antibiotic use associated with poor outcomes in community-onset pneumonia after adjusting for confounders? Methods: We performed a retrospective, observational cohort study of 1995 adults with pneumonia admitted from four US hospital emergency departments. We used multivariable regressions to investigate the effect of broad-spectrum antibiotics on 30-day mortality, length of stay, cost and Clostridioides difficile infection (CDI).