Clinical studiesEffects of guideline-concordant antimicrobial therapy on mortality among patients with community-acquired pneumonia
Section snippets
Study sample
The sample included patients hospitalized at two academic tertiary care hospitals (one Veterans Affairs hospital and one county-run hospital) in San Antonio, Texas, between January 1, 2000, and December 31, 2001. Patients were identified using International Classification of Diseases, Ninth Revision (ICD-9) discharge diagnoses consistent with community-acquired pneumonia: a primary discharge diagnosis of pneumonia (codes 480.0–483.99; 485–487.0), or a primary diagnosis of respiratory failure
Results
Data were abstracted on 420 patients (Table 1). The mean (± SD) age of the cohort was 63 ± 16 years; 85% were men. Seventy-eight percent of patients were admitted through the emergency department, and 20% were admitted to the ICU within the first 24 hours after admission. Mortality was 9.8% (n = 41) at 30 days and 13.8% (n = 58) at 90 days. The mean length of hospital stay was 8.1 ± 9.1 days. Regarding pneumonia-related processes of care, 78% of patients received antibiotics within 8 hours of
Discussion
Community-acquired pneumonia continues to be an acute medical problem and is associated with substantial mortality and morbidity. Our study supports the hypothesis that the use of empiric antimicrobial therapy concordant with national clinical practice guidelines is associated with decreased mortality among patients hospitalized with community-acquired pneumonia, even after adjusting for other potential confounders. Patients who received nonconcordant antimicrobial therapy had an increased risk
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2023, Acta Colombiana de Cuidado IntensivoImpact of Cirrhosis on Pneumonia-Related Outcomes in Hospitalized Older Veterans
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2013, Enfermedades Infecciosas y Microbiologia ClinicaCitation Excerpt :Some studies have shown that adherence to guidelines results in shorter stays and lower mortality. In several studies on community-acquired pneumonia, adherence to the guidelines was an independent protective factor against treatment failure and death.35,36 There are other studies of hospital-acquired pneumonia, ventilator-associated pneumonia, meningitis and sepsis showing similar results: a reduction in antimicrobial use and costs, an increase of initial administration of adequate antimicrobial therapy, a shorten of therapy duration and a decrease of mortality.37–39
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Dr. Mortensen was supported by a Howard Hughes Medical Institute faculty start-up grant (00378-001) and a Department of Veteran Affairs Veterans Integrated Service Network 17 new faculty grant. Dr. Pugh was supported by a Department of Veteran Affairs grant (HFP98-002). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.