Monotherapy versus combination therapy in severe Legionella pneumonia: a multicenter retrospective observational study
Authors' conclusion
Our study suggests that monotherapy, particularly with fluoroquinolones, may be an alternative to combination therapy in managing severe Legionella pneumophila pneumonia in the ICU.
Study context
- Population
- Adults admitted to ICUs for severe Legionella pneumophila pneumonia, French university and general hospitals, 2017–2022
- Participants
- 93 adults
- Exposure
- Antibiotic monotherapy vs combination therapy
- Monotherapyn = 13reference
- Combination therapyn = 80
- Outcome
- 28-day mortality after ICU admission
- Follow-up
- 28 days
Methodological detailsobservational, multicentre
- Observational
- Multicentre
Main finding
As reported in the abstract
28-day mortality
Monotherapy
15.4%
Combination therapy
12.5
Observational data: associations, not effects.
Secondary outcomes
Invasive ventilation duration
- No significant difference, monotherapy vs combination therapy (days)
- 16.5 vs. 10 days
ICU LOS
- No significant difference, monotherapy vs combination therapy (days)
- 12 vs. 11.5 days
90-day mortality
- No significant difference, monotherapy vs combination therapy
- 23.1% vs. 16.25%
Safety
Antibiotic-related adverse events
- Antibiotic-related adverse events — Cutaneous rash
- n = 7; 87.5%
- Antibiotic-related adverse events — Confusion
- n = 1 ;12.5%
Antibiotic-related adverse events
- Not significantly different between the two groups
Original publication
Monotherapy versus combination therapy in severe Legionella pneumonia: a multicenter retrospective observational study. Crit Care. Published 28 February 2026. doi:10.
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