Guideline-concordant antibiotic use and survival among patients with community-acquired pneumonia admitted to the intensive care unit

Frei, Christopher R.; Attridge, Russell T.; Mortensen, Eric M.; Restrepo, Marcos I.; Yu, Yifan; Oramasionwu, Christine U.; Ruiz, Jessica; Burgess, David S.

doi:10.1016/j.clinthera.2010.02.006

Cited by 86 publications

(43 citation statements)

References 20 publications

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“…(9) However, it is of note that, in that study, the treatment regimens recommended for ICU patients were different from those recommended in the Brazilian guidelines.…”

Section: Discussionmentioning

confidence: 85%

“…(4) Although there is no consensus in the literature, various studies have shown that the systematic use of CAP guidelines results in an increase in the proportion of patients treated as outpatients (with no worsening of outcomes), as well as in a reduction in 30-day mortality, in-hospital mortality, length of hospital stay, time to clinical stability, and complications in those treated as inpatients. (5)(6)(7)(8)(9) The primary objective of the present study was to evaluate the agreement between the criteria used for hospitalization of CAP patients in the Hospital das Clínicas da Universidade Federal de Minas Gerais (HC/UFMG, Federal University of Minas Gerais Hospital das Clínicas), located in the city of Belo Horizonte, Brazil, in the 2005-2007 period and those of the Brazilian Thoracic Association guidelines, as well as to evaluate the association of that agreement with 30-day mortality. The secondary objective of the study was to evaluate the association between the agreement of the treatment given with that recommended in the Brazilian guidelines for CAP and length of hospital stay, microbiological profile, 12-month mortality, incidence of complications, need for ICU admission, need for mechanical ventilation, and variables associated with 30-day mortality.…”

Section: Introductionmentioning

confidence: 99%

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Adesão a diretrizes e impacto nos desfechos em pacientes hospitalizados por pneumonia adquirida na comunidade em um hospital universitário

2012

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Objective: To evaluate the agreement between the criteria used for hospitalization of patients with communityacquired pneumonia (CAP) and those of the Brazilian Thoracic Association guidelines, and to evaluate the association of that agreement with 30-day mortality. Secondarily, to evaluate the agreement between the treatment given and that recommended in the guidelines with length of hospital stay, microbiological profile, 12-month mortality, complications, ICU admission, mechanical ventilation, and 30-day mortality. Methods: This was a retrospective study involving adult patients hospitalized between 2005 and 2007 at the Federal University of Minas Gerais Hospital das Clínicas, located in Belo Horizonte, Brazil. Medical charts and chest X-rays were reviewed. Results:Among the 112 patients included in the study, admission and treatment criteria were in accordance with the guidelines in 82 (73.2%) and 66 (58.9%), respectively. The 30-day and 12-month mortality rates were 12.3% and 19.4%, respectively. The 30-day mortality rate was lower for patients in whom the CRB-65 (mental Confusion, Respiratory rate, Blood pressure, and age ≥ 65 years) score was 1-2 and the antibiotic therapy was in accordance with the guidelines (p = 0.01). Cerebrovascular disease and appropriate antibiotic therapy showed independent associations with 30-day mortality. There was a trend toward an association between guidelineconcordant antibiotic therapy and shorter hospital stay. Conclusions: In the population studied, admission and treatment criteria that were in accordance with the guidelines were associated with favorable outcomes in hospitalized patients with CAP. Cerebrovascular disease, as a risk factor, and guideline-concordant antibiotic therapy, as a protective factor, were associated with 30-day mortality.Keywords: Pneumonia/therapy; Pneumonia/mortality; Hospitalization; Guideline adherence. ResumoObjetivo: Avaliar a concordância entre os critérios de hospitalização utilizados para a admissão de pacientes com pneumonia adquirida na comunidade (PAC) e aqueles da Sociedade Brasileira de Pneumologia e Tisiologia e avaliar a associação dessa concordância com a taxa de mortalidade em 30 dias. Secundariamente, avaliar a associação da concordância entre o tratamento instituído e as recomendações dessas diretrizes com duração da internação hospitalar, investigação microbiológica, mortalidade em 12 meses, complicações, internação em UTI, ventilação mecânica e mortalidade em 30 dias. Métodos: Estudo retrospectivo que incluiu pacientes adultos internados entre 2005 e 2007 no Hospital das Clínicas da Universidade Federal de Minas Gerais, na cidade de Belo Horizonte (MG). Foram revisados prontuários e radiografias de tórax. Resultados: Dentre os 112 pacientes incluídos, os critérios de internação e de tratamento foram concordantes com as diretrizes em 82 (73,2%) e 66 (58,9%), respectivamente. A taxa de mortalidade em 30 dias e em 12 meses foi de 12,3% e 19,4%, respectivamente. Pacientes com escore de CRP-65 (Confusão mental, frequênci...

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“…(9) However, it is of note that, in that study, the treatment regimens recommended for ICU patients were different from those recommended in the Brazilian guidelines.…”

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Adesão a diretrizes e impacto nos desfechos em pacientes hospitalizados por pneumonia adquirida na comunidade em um hospital universitário

2012

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“…Hospitalisation rates differ widely between European countries, ranging from 20-50%, meaning that there are about 1 million hospital admissions for CAP per year in the EU (Welte et al, 2012). The 90-day mortality rate in the P patient population may reach 14%; post-hospitalisation mortality is still considerably high within a year after discharge, in comparison to the general population and to patients hospitalised for other reasons (Wunderink and Waterer, 2014), However, mortality does not seem to be related to antibiotic resistance (Frei et al, 2010). CAP is associated with a significant increase in the risk of cardiovascular events and death from cardiac causes.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers in Community-Acquired Pneumonia Assessment

Voskresenska

Babikovs

Voicehovska

et al. 2017

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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“…Treatment of this acute disease consists of lung-protective mechanical ventilation (Moloney & Griffiths, 2004) and, in the most severe cases, of extra-corporeal membrane oxygenation (ECMO) (Bonacchi et al, 2012;Combes et al, 2012a,b;Davies et al, 2009;Lewandowski, 2000;Tiruvoipati et al, 2012). Effective treatment requires regular adjustments to the anti-infectious therapy (File, 2009;Frei et al, 2010;Mandell et al, 2007). However, the pathogen is not always easily identifiable or even known.…”

Section: Introductionmentioning

confidence: 99%

A severe case of pneumopathy in a duck breeder due to Chlamydia psittaci diagnosed by 16S rDNA sequencing

Carlier¹,

Kempf²,

Aaziz

et al. 2014

JMM Case Reports

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Guideline-concordant antibiotic use and survival among patients with community-acquired pneumonia admitted to the intensive care unit

Cited by 86 publications

References 20 publications

Adesão a diretrizes e impacto nos desfechos em pacientes hospitalizados por pneumonia adquirida na comunidade em um hospital universitário

Adesão a diretrizes e impacto nos desfechos em pacientes hospitalizados por pneumonia adquirida na comunidade em um hospital universitário

Biomarkers in Community-Acquired Pneumonia Assessment

A severe case of pneumopathy in a duck breeder due to Chlamydia psittaci diagnosed by 16S rDNA sequencing

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