TY - JOUR
T1 - Evaluation of management of uncomplicated community-acquired pneumonia
T2 - A retrospective assessment
AU - Walsh, Thomas L.
AU - Di Silvio, Briana E.
AU - Speredelozzi, Daniel
AU - Hammer, Crystal D.
AU - Hu, Kurt
AU - Abdulmassih, Rasha
AU - Makadia, Jina T.
AU - Sandhu, Rikinder
AU - Naddour, Mouhib
AU - Vishwanathan, Swati
AU - Chan-Tompkins, Noreen H.
AU - Trienski, Tamara L.
AU - Moffa, Matthew A.
AU - Bremmer, Derek N.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background: Community-acquired pneumonia (CAP) remains a leading cause of hospitalization andmortality in the United States. Studies have shown that interventions such as shorter antibiotic therapy and early intravenous (IV) to oral conversion can be safely performed.We evaluated areas of improvement at our institutions that could help optimize patient managementwhile reducing collateral damage associatedwith excessive antibiotic usage. Methods: In this retrospective analysis, all patients aged 18 years and older with a primary International Classification of Diseases, Ninth Revision code for CAP admitted from March 1, 2014, to October 31, 2014, were analyzed. The primary outcome was duration of antibiotic therapy for uncomplicated CAP (appropriate treatment duration defined as 7 days or less). Secondary objectives included duration of IVantibiotic therapy, duration of inpatient length of stay, and 30-day readmission rate related to CAP. Results: Of the 141 patients evaluated, 98 (69.5%) met inclusion criteria. The mean total duration of antibiotic therapy was 10.1 ± 3.4 days, and the mean duration of IV therapy was 4.9 ± 3.3 days. Only 26.5% of patients received 7 days or less of antibiotic therapy, whereas 38.8% received greater than 10 days of therapy. Conclusions: Our findings are concerning given the available data demonstrating that short-course therapy with 5 to 7 days is clinically as effective as long-course therapy and associated with fewer adverse events. The management of uncomplicatedCAP represents a significant opportunity for antimicrobial stewardship intervention.
AB - Background: Community-acquired pneumonia (CAP) remains a leading cause of hospitalization andmortality in the United States. Studies have shown that interventions such as shorter antibiotic therapy and early intravenous (IV) to oral conversion can be safely performed.We evaluated areas of improvement at our institutions that could help optimize patient managementwhile reducing collateral damage associatedwith excessive antibiotic usage. Methods: In this retrospective analysis, all patients aged 18 years and older with a primary International Classification of Diseases, Ninth Revision code for CAP admitted from March 1, 2014, to October 31, 2014, were analyzed. The primary outcome was duration of antibiotic therapy for uncomplicated CAP (appropriate treatment duration defined as 7 days or less). Secondary objectives included duration of IVantibiotic therapy, duration of inpatient length of stay, and 30-day readmission rate related to CAP. Results: Of the 141 patients evaluated, 98 (69.5%) met inclusion criteria. The mean total duration of antibiotic therapy was 10.1 ± 3.4 days, and the mean duration of IV therapy was 4.9 ± 3.3 days. Only 26.5% of patients received 7 days or less of antibiotic therapy, whereas 38.8% received greater than 10 days of therapy. Conclusions: Our findings are concerning given the available data demonstrating that short-course therapy with 5 to 7 days is clinically as effective as long-course therapy and associated with fewer adverse events. The management of uncomplicatedCAP represents a significant opportunity for antimicrobial stewardship intervention.
KW - Antibiotic utilization
KW - Community-acquired pneumonia
KW - Respiratory tract infections
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U2 - 10.1097/IPC.0000000000000468
DO - 10.1097/IPC.0000000000000468
M3 - Article
AN - SCOPUS:84995776546
SN - 1056-9103
VL - 25
SP - 71
EP - 75
JO - Infectious Diseases in Clinical Practice
JF - Infectious Diseases in Clinical Practice
IS - 2
ER -