Pneumonia Severity Scores and Prescribing Antibiotics for Community‐Acquired Pneumonia at an Australian Hospital

Abstract

Aim To evaluate the use of pneumonia severity scores for diagnosing community‐acquired pneumonia (CAP) and to assess whether antibiotic prescribing was compliant with guidelines as determined by the calculated pneumonia severity score. Method A retrospective chart review was undertaken of consecutive adults admitted via the emergency department with a diagnosis of CAP during a 6‐month period. Charts were reviewed for symptoms and radiographic evidence of pneumonia and for recorded pneumonia severity scores. Pneumonia severity scores were calculated using CORB, CURB‐65 and SMART‐COP for patients with available data and used to assess compliance with the Therapeutic Guidelines: Antibiotic. Results Of the 204 patients reviewed Of the 204 patients reviewed CURB‐65 and SMART‐COP scores for the remaining 68 patients, 13 (19%), 3 (4.4%) and 1 (3.6%) patients had severe pneumonia. 93% of patients received ceftriaxone. An average of 8% of patients were prescribed antibiotics compliant with the Therapeutic Guidelines: Antibiotic. Compliance varied with the pneumonia severity scoring tool used. Conclusion Pneumonia severity scores were rarely calculated to guide treatment and antibiotic prescribing for CAP. Compliance with the Therapeutic Guidelines: Antibiotic was poor and varied with the pneumonia severity scoring tool used. An easy‐to‐use pneumonia severity score to guide patient admission and choice of antibiotic is needed.

Adherence to Guidelines for Assessment and Empiric Antibiotics Recommendations for Community-Acquired Pneumonia at Ambo University Referral Hospital: Prospective Observational Study

“…Studies reveal that the documented use of a pneumonia severity score is extraordinarily low (5%). 24 , 25 Besides, several studies showed a very poor recording of the CAP severity score. 18 , 20 , 26 Assessing the CURB-65 score helps physicians to classify patients and select appropriate antimicrobial therapy concerning the patient site of care.…”

Community-acquired pneumonia: why aren't national antibiotic guidelines followed?

“…However, we found the use of a scoring tool was rarely recorded in medical notes (11.9%). A recent Australian study showed even poorer documentation of severity tools, where only one out of 69 patients had a severity score documented . In our study, even when a severity score was documented, the TG14 recommended tools (SMART‐COP/CORB) were only utilised in 1% of cases, other severity scoring tools such as CURB65 and PSI were used more frequently.…”

Adherence to Therapeutic Guidelines for Patients with Community-Acquired Pneumonia in Australian Hospitals

“…However, a study by Maxwell et al reveals that documented use of a pneumonia severity score in Australian hospitals is extraordinarily low (5%) 11. Numerous studies have revealed that there is poor recording of CAP severity scores in clinical documentation 12–14. At our institution, the CORB score was not documented in any of the medical records of over 250 patients admitted with CAP in 2012.…”

“…11 Numerous studies have revealed that there is poor recording of CAP severity scores in clinical documentation. 1214 At our institution, the CORB score was not documented in any of the medical records of over 250 patients admitted with CAP in 2012. This may reflect a lack of awareness or perceived usefulness of pneumonia severity assessment tools.…”