Early Administration of Antibiotics Does Not Shorten Time to Clinical Stability in Patients With Moderate-to-Severe Community-Acquired Pneumonia *

Silber, Steven H.; Garrett, Christopher; Singh, Rakesh; Sweeney, Angela; Rosenberg, Carl; Parachiv, Diana; Okafo, Tobi

doi:10.1378/chest.124.5.1798

Cited by 83 publications

(45 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The same is true for the initiation of aggressive fluid resuscitation in severe CAP with severe sepsis [37]. The evidence in favour of a door-toantibiotic time in patients without septic shock is less clear [38][39][40][41][42]. It probably heavily depends on the populations studied.…”

Section: Pre-hospital and Early In-hospital Carementioning

confidence: 99%

Community-acquired pneumonia as an emergency: time for an aggressive intervention to lower mortality

Ewig¹,

Torres²

2011

European Respiratory Journal

View full text Add to dashboard Cite

Community-acquired pneumonia (CAP) is one of the major contemporary acute lifethreatening conditions. Short-term mortality reaches 14% (7% if nursing-home residents and bedridden patients are excluded) and long-term mortality reaches 50% within 5 yrs.CAP and acute myocardial infarction (AMI) have a lot in common with regard to acuity, prognosis, need for risk stratification and early intervention, and secondary prevention measures. The obvious success in the treatment of AMI is due to an effective organisation of pre-hospital care and evidence-based interventions in the hospital within defined timescales.Less evidence is available about effective strategies to lower short-and long-term mortality in patients with CAP. Nevertheless, it is estimated that ,30% of hospitalised patients with CAP could be subject to a management approach in parallel to that of acute coronary syndrome (ACS).Management of patients with severe CAP should be intensified using all elements that have been established in the care for patients with ACS and stroke. One of the main challenges of future research will be to define whether and which additional patients at risk of mortality truly profit from timely and structured interventions. In the meantime, patients at increased risk of death according to clinical prediction tools should also be subject to an aggressive management approach.

show abstract

Section: Pre-hospital and Early In-hospital Carementioning

confidence: 99%

Community-acquired pneumonia as an emergency: time for an aggressive intervention to lower mortality

Ewig¹,

Torres²

2011

European Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…Two smaller studies of CAP found no association between early antibiotic administration and outcomes (10,11). Nevertheless, the authors of the 2004 study (9) editorialized that the 4-hour TFAD quality measure was still valid (12,13).…”

Section: Tfad As a Quality Measurementioning

confidence: 99%

Public Reporting of Antibiotic Timing in Patients with Pneumonia: Lessons from a Flawed Performance Measure

et al. 2008

View full text Add to dashboard Cite

“…A short time to first antibiotic dose (TFA) for patients hospitalised with CAP was initially suggested to decrease mortality 7,8 and later hospital length of stay (LOS), [9][10][11] findings which have since been vigorously disputed. [12][13][14][15][16][17][18] A number of reports have also been published showing an increase in both the CAP misdiagnosis rate and the proportion of patients inappropriately administered antibiotics following the introduction of clinical care pathways advocating a short TFA in all patients with suspected CAP. [19][20][21] International guidelines recommend that CAP be definitively diagnosed with the use of a chest radiograph.…”

Section: Introductionmentioning

confidence: 99%

The impact of an early chest radiograph on outcome in patients hospitalised with community-acquired pneumonia

2010

View full text Add to dashboard Cite

-Patients admitted to UK hospitals with community-acquired pneumonia (CAP) require a chest radiograph for diagnostic purposes and to look for complications. This study investigated the association between a chest radiograph performed early in the process of care and clinical outcomes. Consecutive adults admitted with CAP to a large UK teaching hospital trust over a nine-month period were prospectively studied (n‫؍‬ ‫.)164؍‬ A time to first radiograph of <4 hours was associated with a significantly shorter median length of hospital stay (LOS) compared with у у4 hours (5.75 days versus 7.13 days, pϽ Ͻ0.01). Antibiotics were administered after the radiograph in 89.8% of patients with a time to first radiograph Ͻ Ͻ4 hours compared with 40.7% of patients with time to first radiograph of у у4 hours (odds ratio 12.8, pϽ Ͻ0.001). A chest radiograph performed within four hours of hospital admission for CAP is significantly associated with a shorter hospital LOS and with antibiotic use after chest radiography.

show abstract

Early Administration of Antibiotics Does Not Shorten Time to Clinical Stability in Patients With Moderate-to-Severe Community-Acquired Pneumonia *

Cited by 83 publications

References 17 publications

Community-acquired pneumonia as an emergency: time for an aggressive intervention to lower mortality

Community-acquired pneumonia as an emergency: time for an aggressive intervention to lower mortality

Public Reporting of Antibiotic Timing in Patients with Pneumonia: Lessons from a Flawed Performance Measure

The impact of an early chest radiograph on outcome in patients hospitalised with community-acquired pneumonia

Contact Info

Product

Resources

About