Updated Acute Community-Acquired Pneumonia in Adults: Guidelines for Initial Antimicrobial Therapy Based on Local Evidence from the South American Working Group (Consensur II)

Bantar, Carlos; Curcio, Daniel; Jasovich, Abel; Bagnulo, Homero; Arango, Álvaro; Bavestrello, Luis; Famiglietti, Ángela; García, Patricia; Lopardo, Gustavo; Losanovscky, Miriam; Martínez, Ernesto; Pedreira, Walter; Piñeyro, Luis; Remolif, Christian; Rossi, Flávia; Varón, Fabio Andrés

doi:10.2174/157339810791171223

Cited by 6 publications

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“…Then, 88 out of 4125 references were identified for possible inclusion, after 23 duplicated were removed, 38 papers were excluded (Figure ). Accordingly, 18 publications met our inclusion criteria …”

Section: Resultsmentioning

confidence: 99%

“…About the 18 CPGs selected: there is an American guideline (IDSA), one is from Brazil, one from Italy (Gulf), one from India, two European (ERS and Multidisciplinary), two from Spain (SEPAR and Andalusian), a Peruvian guideline, a Dutch guideline (SWAB), two British guidelines (NICE and BTS), a Lebanese guideline, one from Latin America (Consensur), one Colombian guideline, one Chinese, one Korean and one Swedish …”

Section: Resultsmentioning

confidence: 99%

“…Accordingly, 18 publications met our inclusion criteria. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] As shown in Figure 1, the reason for exclusion were as follows:…”

Section: Re Sultsmentioning

confidence: 99%

“…[49][50][51][52] CPGs that included pneumonia associated with health care, 53,54 audit, 55 note, 56 summary and comment, 57 "Consensus statements", [58][59][60][61][62] reviews, [63][64][65] includes various types of infections not only pneumonia, 66,67 description of adaptation of a CPG, 68 newsletter, 69 very little information available, 70 updated guidelines, [71][72][73] could not be downloaded the full version, 74 and there was a special case of a CPG published in different journals in the same year and it was excluded because it was a consensus on the two different publications. 58,59 About the 18 CPGs selected: there is an American guideline (IDSA), 34 one is from Brazil, 33 one from Italy (Gulf), 22 one from India, 27 two European (ERS and Multidisciplinary), 20,28 two from Spain (SEPAR and Andalusian), 21,31 a Peruvian guideline, 23 a Dutch guideline (SWAB), 29 two British guidelines (NICE and BTS), 17,32 a Lebanese guideline, 18 one from Latin America (Consensur), 30 one Colombian guideline, 24 one Chinese, 25 one Korean 26 and one Swedish. 19…”

Section: Re Sultsmentioning

confidence: 99%

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Clinical practice guidelines for the management of community‐acquired pneumonia: A critical appraisal using the AGREE II instrument

et al. 2020

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Summary Objective The aim of this study was to appraise the methodological quality of published clinical practice guidelines (CPGs) of community‐acquired pneumonia (CAP) using AGREE II instrument for further enhancing the CAP CPG development. Methods We performed a systematic review of published CPGs on CAP from January 2007 to May 2019. All reviewers independently assessed each CPG using the AGREE II instrument. A standardised score was calculated for each of the six domains. Results Our search strategy identified 4125 citations but just 18 met our inclusion criteria. Agreement among reviewers was very good: 0.98. The domains that scored better were: “scope and purpose” and “clarity and presentation”. Those that scored worse were “editorial independence”, and “applicability”. According to the AGREE II evaluation for each Guideline, the NICE, IDSA, BTS, SWAB, Korea, Consensur II, Colombian and Peruvian CPGs were the only recommended with no further modifications. In addition, ERS and SEPAR CPGs were recommended with modifications, with lower scores regarding the editorial independence and applicability. Conclusion In conclusion, published CPGs for CAP management vary in quality with a need to improve the methodological and applicability rigour. This could be achieved following the standards for guidelines development and a better emphasis on how to apply CPGs recommendations in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Re Sultsmentioning

confidence: 99%

Section: Re Sultsmentioning

confidence: 99%

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Clinical practice guidelines for the management of community‐acquired pneumonia: A critical appraisal using the AGREE II instrument

et al. 2020

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“…(24) Therefore, the use of a beta-lactam antibiotic in isolation (when recommended) is reserved for low-risk patients without comorbidities or aggravating factors. (20,25) Although we found a significant proportion of patients receiving a beta-lactam antibiotic in isolation (i.e., 21.4%, excluding those treated for aspiration pneumonia), 66.7% of those had a CURB-65 score of 0-1 or a CRB-65 score of 0. However, we did not compare that specific group of patients with low-risk patients receiving treatment in accordance with the Brazilian guidelines in terms of outcomes.…”

Section: Discussionmentioning

confidence: 80%

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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Redefining risk categories for pneumococcal disease in adults: critical analysis of the evidence

Curcio

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Istúriz

2015

International Journal of Infectious Diseases

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Updated Acute Community-Acquired Pneumonia in Adults: Guidelines for Initial Antimicrobial Therapy Based on Local Evidence from the South American Working Group (Consensur II)

Cited by 6 publications

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Clinical practice guidelines for the management of community‐acquired pneumonia: A critical appraisal using the AGREE II instrument

Clinical practice guidelines for the management of community‐acquired pneumonia: A critical appraisal using the AGREE II instrument

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

Redefining risk categories for pneumococcal disease in adults: critical analysis of the evidence

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