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[Adherence to antibiotherapy guidelines for acute community-acquired pneumonia in adults, in a teaching hospital.]

Med Mal Infect. 2010 Feb 17;

Authors: Martinez JS, Le Falher G, Corne P, Bourdin A, Lequellec A, Delabre JP, Makinson A, Hansel S, Reynes J, Le Moing V

OBJECTIVE: The authors had for aim to assess the conformity of antibiotic prescription with guidelines, for the management of community-acquired pneumonia, in a French University Hospital. DESIGN: This prospective study included adults patients hospitalized for pneumonia over a period of six months. The attending physician estimated the severity of pneumonia. The adequacy to guidelines focused on: first antibiotic choice and prescription modality, antibiotic choice in case of treatment modification at 48 to72hours, and duration of antibiotherapy. RESULTS: A hundred and nine cases of pneumonia were included in 106 patients. The mean age was 66 years, the mortality rate was 17 %. Bacterial documentation was recorded in 40.4 % of cases. The first antibiotics used were in accordance with guidelines in 52.3 % of cases. The non conformity rate was minor in 55.8 % of cases. Antibiotherapies putting the patient at risk were used in less than 10 % of the cases. The rate of antibiotic modification at 48 to 72hours was 46.8 %, primarily for bacteriological purposes (35.3 %) or initial treatment failure (27.4 %). The treatment duration was inappropriate in 52.7 % of cases and generally too long in case of non conformity. CONCLUSION: It seems important to support guideline information, training of prescribers, and to consult an antibiotic expert.

PMID: 20171030 [PubMed - as supplied by publisher]

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