Reevaluation of the Japanese guideline for healthcare-associated pneumonia in a medium-sized community hospital in Japan

Oshitani, Yohei; Nagai, Hirokazu; Matsui, Hirotoshi; Aoshima, Masahiro

doi:10.1007/s10156-012-0517-1

Cited by 39 publications

(33 citation statements)

References 24 publications

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“…Oshitani et al reported 477 NHCAP patients with a mean age of 84 years; the mortality rate during hospitalization was 24.7%; and the percentage of patients initially treated with ABPC/SBT was 64.6% [20]. Similar to the present study, the percentages of patients initially receiving ABPC/SBT were high, and the mortality rates during hospitalization were comparable.…”

Section: Discussionsupporting

confidence: 86%

Effects of Ampicillin/Sulbactam Dose and Dosing Frequency in Elderly Patients with Nursing- and Healthcare-Associated Pneumonia (Nhcap)

Yamazaki¹,

Sugawara²

2016

J Infect Dis Ther

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Japan has the most rapidly aging population in the world. This study aimed to examine the differences in the efficacy of ampicillin/sulbactam (ABPC/SBT) alone under different daily doses and daily dosing frequencies in elderly patients receiving healthcare at home and in elderly nursing home residents with pneumonia onset requiring hospitalization for treatment. By applying the Clinical Practice Guidelines for Nursing-and Healthcare-associated Pneumonia (NHCAP) of the Japanese Respiratory Society (JRS), we retrospectively analyzed clinical data, dose, dosing period, and the efficacy of antimicrobial agents, as well as outcomes of patients with NHCAP or community acquired pneumonia (CAP) who had been hospitalized at our department during the 3-year period of 2009 through 2011. The mean age of NHCAP patients (n=587) was 85 ± 9 years, significantly higher than the 77 ± 16 years of CAP patients (n=319). The serum albumin level in NHCAP patients was significantly lower than that in CAP patients. Among NHCAP patients, 82.5% received ABPC/SBT alone as the first-line therapy, with 50.7% receiving 1.5 g three times daily and 22.8% receiving 3 g twice daily. The mortality rate during hospitalization in the 1.5-g three-times-daily group was 12.4%, resulting in a significantly decrease as compared with the 3-g twice-daily group of 20.9% (p<0.01). In our study, which targeted the elderly in Japan, it was revealed that ABPC/SBT is an appropriate first choice of antibiotics in treating NHCAP and that administering 1.5 g three times daily is a suitable way of administration.

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Section: Discussionsupporting

confidence: 86%

Effects of Ampicillin/Sulbactam Dose and Dosing Frequency in Elderly Patients with Nursing- and Healthcare-Associated Pneumonia (Nhcap)

Yamazaki¹,

Sugawara²

2016

J Infect Dis Ther

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“…We excluded 26 of the remaining 45 records after retrieving and inspecting the full text. The reasons for exclusion were: the population included inappropriate subjects (n = 5)3233343536, mismatched outcomes (n = 7)23373839404142, no description of aspiration pneumonia or the definition of aspiration pneumonia did not meet a priori criteria (n = 14)4344454647484950515253545556. The process of the study selection is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis

Komiya

Rubin

Kadota

et al. 2016

Sci Rep

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Aspiration pneumonia is thought to be associated with a poor outcome in patients with community acquired pneumonia (CAP). However, there has been no systematic review regarding the impact of aspiration pneumonia on the outcomes in patients with CAP. This review was conducted using the MOOSE guidelines: Patients: patients defined CAP. Exposure: aspiration pneumonia defined as pneumonia in patients who have aspiration risk. Comparison: confirmed pneumonia in patients who were not considered to be at high risk for oral aspiration. Outcomes: mortality, hospital readmission or recurrent pneumonia. Three investigators independently identified published cohort studies from PubMed, CENTRAL database, and EMBASE. Nineteen studies were included for this systematic review. Aspiration pneumonia increased in-hospital mortality (relative risk, 3.62; 95% CI, 2.65–4.96; P < 0.001, seven studies) and 30-day mortality (3.57; 2.18–5.86; P < 0.001, five studies). In contrast, aspiration pneumonia was associated with decreased ICU mortality (relative risk, 0.40; 95% CI, 0.26–0.60; P < 0.00001, four studies). Although there are insufficient data to perform a meta-analysis on long-term mortality, recurrent pneumonia, and hospital readmission, the few reported studies suggest that aspiration pneumonia is also associated with these poor outcomes. In conclusion, aspiration pneumonia was associated with both higher in-hospital and 30-day mortality in patients with CAP outside ICU settings.

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“…In contrast, the present study involved >24 000 community‐dwelling older adults, and has provided evidence that snoring was associated with wheezing and expectoration in this population. Both of these airway symptoms are also related to aspiration in older adults, and can result in aspiration pneumonia, a major cause of mortality in Japan . Snoring could thus identify individuals with a higher risk of mortality and impaired quality of life.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical impact of snoring in older community‐dwelling adults

Wada

Furuya

Maruyama

et al. 2019

Geriatrics Gerontology Int

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Aim The prevalence and clinical impact of snoring in the independent older adult population is unknown. To address this, we carried out this cross‐sectional epidemiological study of community‐dwelling independent older adults. Methods The study data were collected by the Japan Gerontological Evaluation Study 2013, a postal survey distributed to a large cohort of independent community‐dwelling older adults (aged ≥65 years) in 2013, across 30 municipalities of 14 prefectures. We used data for 24 837 participants (13 135 women, mean age 73.5 years, and 11 702 men, mean age 73.3 years). The association of snoring with airway symptoms and history of hypertension, diabetes and heart disease were investigated using Poisson regression models. Results The prevalence ratio (95% confidence intervals) for wheezing according to snoring frequency in men was 1.87 (1.45–2.43) among those who snored on 1–6 nights a week, and 2.95 (2.15–4.05) among those who snored every night. Similar relationships were observed for women. Expectoration, another airway symptom, was also associated with snoring frequency. Furthermore, snoring frequency was associated with a higher prevalence of hypertension, diabetes and heart disease. Both diabetes and heart disease were associated with snoring frequency in women independent of body mass index, but the association was only observed in men with a normal or lower body mass index. Conclusions Snoring is a highly prevalent and pathogenic symptom in adults aged ≥65 years. Geriatr Gerontol Int 2019; 19: 1165–1171.

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Reevaluation of the Japanese guideline for healthcare-associated pneumonia in a medium-sized community hospital in Japan

Cited by 39 publications

References 24 publications

Effects of Ampicillin/Sulbactam Dose and Dosing Frequency in Elderly Patients with Nursing- and Healthcare-Associated Pneumonia (Nhcap)

Effects of Ampicillin/Sulbactam Dose and Dosing Frequency in Elderly Patients with Nursing- and Healthcare-Associated Pneumonia (Nhcap)

Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis

Prevalence and clinical impact of snoring in older community‐dwelling adults

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