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We had limited data regarding escalation of therapy, and only recorded whether new antibiotics were started or substituted after 24?h of hospitalization. Our primary outcome measure was in-hospital mortality. In addition, we examined ICU admissions and the composite endpoint of in-hospital mortality or ICU admission. Baseline characteristics of patients receiving guideline-concordant vs. discordant antibiotics were compared using parametric or non-parametric tests, as appropriate. Multivariable logistic regression was used to determine the independent association between receipt of guideline-concordant antibiotics and outcomes. We forced use of guideline-concordant antibiotics (dichotomous variable representing the independent exposure of interest), the PSI (continuous selleck summary measure of pneumonia severity calculated using 20 variables: age, sex, nursing home status, five co-morbidities, five physical signs and seven laboratory findings), pre-morbid functional status and board-certified radiologist confirmation of pneumonia by chest radiograph into all models. Because the PSI already includes age, sex and nursing home residence, we did not further adjust for them. We then considered other variables based on clinical importance, univariate p-values ?10% change in beta-coefficient) the association Cefaloridine between antibiotics and outcomes, irrespective of statistical significance. The final models included the forced variables, any variable with an adjusted p-value find more or any confounding variable. We tested all first-order interaction terms, but none achieved statistical significance and none were included in the models. We considered a p-value of