Clinical management of immunocompetent hospitalized patients with community-acquired pneumonia.

Details

Serval ID
serval:BIB_68F010530FA1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical management of immunocompetent hospitalized patients with community-acquired pneumonia.
Journal
European journal of internal medicine
Author(s)
Lamy O., Van Melle G., Cornuz J., Burnand B.
ISSN
0953-6205
Publication state
Published
Issued date
2004
Volume
15
Number
1
Pages
28-34
Notes
Publication types: JOURNAL ARTICLE - Publication Status: ppublish
Abstract
Background: Clinical practices and guidelines may differ regarding the management of inpatients with community-acquired pneumonia (CAP). Methods: The management of 152 consecutive CAP inpatients (70+/-17 years) admitted to a teaching hospital was analyzed retrospectively and compared with published data and an evidence-based guideline developed at our institution. Results: Of the patients studied, 64% had a high prognostic score index (PSI), 14% were admitted to the ICU, and 4.6% died. Initially, patients received either a one-drug (47%) or a two-drug (53%) antibiotic regimen. None of the 20 PSI parameters, and neither the PSI nor admission to the ICU, was associated with the initial antibiotic regimen. Agreement between current practice and our guideline was low (kappa=0.16). Following the recommendations would have led to a decrease of 51% in the initial two-drug regimen. The duration of i.v. antibiotherapy was higher in patients following the two-drug regimen (142+/-150 vs. 102+/-60 h, P<0.05). Chest physiotherapy (CP) and bronchodilatators (BD) were prescribed in 72% and 54% of cases, respectively (median duration 10 days). Conclusions: The variations observed in the clinical management of CAP inpatients were not in agreement with published guidelines. The overuse of a two-drug regimen, CP, and BD necessitates the development and implementation of evidence-based guidelines proposing detailed steps for the management of CAP inpatients.
Pubmed
Create date
05/03/2008 15:57
Last modification date
20/08/2019 14:24
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