RECURRENCE OF PNEUMONIA IN MIDDLE-AGED AND ELDERLY ADULTS AFTER HOSPITAL-TREATED PNEUMONIA - ETIOLOGY AND PREDISPOSING CONDITIONS

In order to investigate the predisposing conditions and aetiologic age nts in patients with recurrent pneumonia, we prospectively studied 653 immunocompetent patients, 50-85 years of age, who had been treated in hospital for community-acquired pneumonia. After an average patient f ollow-up period of 32 months, 11 variables were examined for associati on with the following end points: death, recurrence of pneumonia and r ecurrence of pneumococcal pneumonia. During the follow-up period there were 171 episodes of pneumonia in 115 of the 653 patients, and 52 dea ths (all causes), Multivariate analysis showed that age, male sex, con gestive heart failure and presence of other chronic diseases were sign ificantly associated with higher mortality, Age and chronic pulmonary disease were associated with recurrence of pneumonia. The major aetiol ogic agents were Streptococcus pneumoniae (26%), Haemophilus influenza e (11%) and Moraxella catarrhalis (6%). We conclude that pneumonia rec urrences are common in middle-aged and elderly patients after treatmen t in hospital for community-acquired pneumonia, The recurrence risk is higher in elderly patients, and in those with chronic pulmonary disea ses. Given the prominence of H. influenzae and M. catarrhalis found in the present study, these organisms should always be considered when c hoosing the initial antibiotic in patients with recurrent pneumonia.