A Retrospective Study of the Overuse of Extended-Spectrum Antibiotics in Patients With Community-Acquired Pneumonia With Risk for Methicillin-Resistant Staphylococcus aureus and/or Pseudomonas aeruginosa.

Abstract

Background The changing epidemiology of pneumonia is due to aging hosts and the emergence of new pathogens that requireongoing evaluation and updates on antibiotic treatment. Guidelines from the 2019 Infectious Diseases of American Society/American Thoracic Society (IDSA/ATS) provide recommendations for the treatment and management of community-acquired pneumonia (CAP) with risk for methicillin-resistant Staphylococcus aureus (MRSA) and/or Pseudomonas aeruginosa. The objective of this research is to examine patients with CAP with riskfor MSRA and/or Pseudomonas aeruginosa to assess the overuse of extended-spectrum antibiotics. Methods A retrospective study using a convenience sample of medical records from 118 adult patients with CAP with risk factors for MRSA and/or Pseudomonas was completed from August to December 2019. Descriptive analyses were employed to compute the number and percentages of demographic variables (age, gender), overuse of antibiotics, duration of treatment, and risk factors. Results Of 118 patients, 59.3% were males and 77.9% were aged 60 years and older. Seventy-four percent (74%) of patients were prescribed extended-spectrum antibiotics. Most patients(42%) were treated with extended-spectrum antibiotics and did not meet the risk factors based on the 2019 IDSA/ATS recommended guidelines. Twenty percent (20%) were prescribed antibiotics for eight days or more. Patients with known risk factors, including low positive blood (5%) and respiratory (26%) cultures, antibiotic use (25%), and admission to the hospital within 90 days (30%) were identified. Conclusion In this sample, the overuse of antibiotics was high. The significant percentage of patients that were over-treated with extended-spectrum antibiotics could lead to adverse outcomes.