Comparison of Ceftriaxone vs. Ampicillin Sulbactam for the Treatment of Community Acquired Pneumonia

Document Type

Conference Proceeding

Publication Date

1-11-2026

Publication Title

Open Forum Infect Dis

Keywords

ceftriaxone, sultamicillin, adult, clinical effectiveness, clinical outcome, cohort analysis, community acquired pneumonia, comorbidity, conference abstract, controlled study, female, hospital readmission, hospitalization, human, major clinical study, male, Michigan, mortality, propensity score, retrospective study, therapeutic equivalence, therapy

Abstract

Background: Community-acquired pneumonia (CAP) is a leading cause of hospitalization and mortality in the United States, accounting for over 4.5 million healthcare visits annually. Ceftriaxone and ampicillin-sulbactam are commonly recommended β-lactams for hospitalized patients with non-severe CAP. However, direct comparisons of their clinical effectiveness remain limited.This study aims to compare clinical outcomes in hospitalized adults with CAP treated with ceftriaxone versus ampicillin-sulbactam. Methods: This was a retrospective propensity -matched cohort study that included a total of n= 10,640 patients admitted to Henry Ford Hospital in Detroit, Michigan for treatment of CAP between January 2022 through August of 2024. The primary outcomes were in-hospital mortality and 30-day mortality. Descriptive statistics were used to summarize patient demographics, comorbidities, and outcomes for both treatment groups. Propensity score matching was used to account for confounding differences between treatment groups. A logistic regression was used to determine the association between covariates of interest and their association with in-hospital mortality or 30-day mortality. Results: A total of n=3,171 patients received ampicillin-sulbactam and n=7,469 received ceftriaxone. After propensity score matching, there was a total of n=6,342 patients with an equal number of (n= 3,171) patients in each treatment group. Overall, 4.5% of patients expired in hospital and 11% expired within 30 days. Among this cohort, 30-day readmission was 12.6% and 60-day readmission was 19.4%. Among the propensity-matched patients, there was no significant difference in 30-day mortality between those treated with ceftriaxone and ampicillin-sulbactam (OR 1.065, 95% CI 0.906-1.254, p=0.445). The adjusted OR for in hospital mortality was 1 (95% CI 0.99-1.01, p=0.9894). Conclusion: This study demonstrates no significant differences in 30-day mortality or in-hospital mortality, between patients treated with ceftriaxone and those treated with ampicillin-sulbactam. These findings support the current IDSA recommendations for therapy showing clinical equivalence of both agents as empiric treatment options for CAP.

Volume

13

First Page

S526

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