AJM Theme Issue: Pulmonology/AllergyClinical research studyImpact of Guideline-Concordant Empiric Antibiotic Therapy in Community-Acquired Pneumonia
Section snippets
Methods
This is a retrospective cohort study of all adult patients hospitalized with community-acquired pneumonia at 5 community hospitals within the Baptist Health-System from November 1, 1999 to April 30, 2000. Institutional Review Board approval was obtained from the Baptist Health-System and The University of Texas Health Science Center at San Antonio before beginning the study.
Results
A total of 631 community-acquired pneumonia patients were managed on the medical ward, and 57% of patients received guideline-concordant antibiotic therapy. The guideline-concordant group comprised patients treated with a β-lactam plus a macrolide (71%) or fluoroquinolone monotherapy (29%). Patients in the guideline discordant group received primarily β-lactam monotherapy (31%) or a β-lactam plus a fluoroquinolone (25%). No other regimen was administered to more than 5% of patients in the
Discussion
Our study is one of several to identify an association between guideline-concordant antibiotic therapy and patient mortality or length of hospital stay.10, 11, 12, 13 However, to our knowledge, this is the first study to demonstrate that guideline-concordant antibiotic therapy is associated with a reduced time to clinical stability and time to switch therapy. This association is paramount because it helps identify a clinical intervention (eg, appropriate empiric antibiotic therapy) that could
Conclusion
Guideline-concordant antibiotic therapy is associated with shorter time to clinical stability, time to switch therapy, decreased length of hospital stay, and improved survival among hospitalized community-acquired pneumonia patients.
Acknowledgment
The authors acknowledge the assistance of the following clinical pharmacists from Baptist Health-System, who assisted with data collection: Brian Barthol, PharmD, Renee Bellanger, PharmD, Donna Burgess, RPh, Paige Cuellar, PharmD, Julie Gilbert, PharmD, Jennifer Hammond, PharmD, Scott Hollis, RPh, Loretta Lemoine, RPh, Andi Lewis, PharmD, Jane Mondino, RPh, Jon Olson, PharmD, Nish Patel, PharmD, Liz Sanchez, RPh, Morris Sauter, PharmD, Thomas Shank, PharmD, Jacque Snow, PharmD, Paige Staudt,
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