Physician adherence to pneumonia guidelines regarding initial regimen choice
Abstract number: 1733_684
Peppas T.A., Matsoukas P., Vlastari H., Sotiropoulos A., Binikos I.D., Kandyla B.D., Tamvakos I., Pappas S.I.
Objective: To assess physicians adherence on pneumonia guidelines (G) regarding the initial regimen chosen.
Methods: All pneumonia admissions were prospectively entered in database and all regimens chosen by the attending physicians were compared to the G available and taught to them by admission date, namely IDSA 2003, BTS 2004, Hellenic IDS 2005 and ERS 2005, as well as AJRCCM 2005; 388 for nosocomial and healthcare-associated pneumonia Outcome and hospital stay (HS) was compared for patients with regimen G concordant (GCR) and non-concordant (GNCR). SPSS programme, time: October 2004 to September 2006
Results: A total of 72 patients (M: 44, F: 28) mean age 72.1 yrs were included. Hospital or nursing home pneumonia consisted 14 of them and previous antimicrobial usage was recorded in 32 (44%) Concordance to any G was noted in 47 (65.3%) and the respective percentages were IDSA G: 65%, BTS G: 64% ERS G: 62% and Hellenic IDS: 46%. Main reason for low concordance to Hellenic G was choice of respiratory quinolone, without prior antimicrobial use. Hospital stay was higher for GNCR (10.2 v 8.4, NS) but mortality was higher (28% v 7% of GCR, p = 0.03, Yates corrected chi-square).
Conclusions: Physicians choice of regimen in pneumonia was concordant to existing G at 65% of cases. There was higher mortality among patients with non concordant regimen, and though confounding factors (mainly severity index) can easily bias a small sample size, this fact underlines guidelines utility and value, warranting a more strict adherence
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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