Outcomes of Patients Hospitalized With Community-Acquired, Health Care–Associated, and Hospital-Acquired Pneumonia

Venditti, Mario; Falcone, Marco; Corrao, Salvatore; Licata, Giuseppe; Serra, Pietro

doi:10.7326/0003-4819-150-1-200901060-00005

Cited by 278 publications

(272 citation statements)

References 18 publications

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“…In this study carried out in the elderly overall adherence to clinical guidelines was poor, because also for CAP it was less than 50%, slightly lower than in other studies [7,8,14], but it was even lower for HAP (29%) and HCAP (25%). The lack of specific microbiological test could, at least, explain the poor adherence among CAP.…”

Section: Discussioncontrasting

confidence: 70%

“…While several studies on adherence to guidelines of empirical antibiotic therapy for CAP have been conducted in medical wards and intensive care units [6,[13][14][15], a relatively small number of studies have investigated adherence in patients with healthcare-associated pneumonias such as HAP or HCAP [7,[16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…Perhaps the fact that HCAP has been only recently recognized in the frame of clinical guidelines as a specific pneumonia type may partially explain such discrepancies, because patients with HCAP were traditionally categorized as CAP [4,14] and therefore not appropriately managed [7]. A possible explanation for the under-recognition of HCAP is the inaccurate documentation collected by physicians at patient hospital admission pertaining to the living environments and/or previous hospitalizations, that are crucial criteria for an accurate identification of HCAP.…”

Section: Discussionmentioning

confidence: 99%

“…Even though several studies have evaluated the degree of adherence to guidelines for empirical antibiotic therapy, especially in CAP [6], very few of them did evaluate adherence for the different categories of pneumonia and its impact on clinical outcomes [7]. Furthermore, a paucity of studies has specifically considered the hospitalized elderly population [8].…”

Section: Introductionmentioning

confidence: 99%

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Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

Rossio¹,

Franchi²,

Ardoino³

et al. 2015

European Journal of Internal Medicine

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Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

Rossio¹,

Franchi²,

Ardoino³

et al. 2015

European Journal of Internal Medicine

View full text Add to dashboard Cite

show abstract

“…However, there is disagreement about whether current HCAP criteria clearly identify patients at risk for MDR, and concerns that over-treatment with broadspectrum antibiotics may produce selection pressure for MDR. [2][3][4] Recently, an intervention to improve guidelinebased treatment of patients with possible MDR pneumonia including HCAP, found that guideline-adherent therapy was associated with increased mortality. 5 Therefore, it is unclear if guideline-based therapy improves outcomes for patients with HCAP.…”

Section: Introductionmentioning

confidence: 99%