Abstract
ABSTRACTBackgroundAdherence to guidelines for community‐acquired pneumonia (CAP) has been shown to improve patient outcomes and slow the emergence of antimicrobial resistance. Guidelines for treating CAP vary considerably.AimTo determine the initial antimicrobial therapy used in hospitalised adults with CAP and to compare it with local and international CAP treatment guidelines.MethodA retrospective cohort study of adults presenting to an Auckland hospital with CAP. Initial choice of antimicrobial therapy was compared to the local hospital guidelines and the British Thoracic Society (BTS), Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) and Swedish Society of Infectious Diseases (SSID) guidelines.ResultsInitial treatment in 177 patients presenting with their first episode of CAP included parenteral cephalosporin (61%), amoxycillin+clavulanate (37%), amoxycillin (2.8%) and macrolide (53%). 83/92 (90%) patients with a CURB‐65 score of 0–1 were treated with a cephalosporin or amoxycillin+clavulanate. 42/85 (49%) patients with a CURB‐65 score ≥ 2 were treated with a macrolide. Adherence with treatment guidelines was 97% (hospital), 53% (IDSA/ATS), 11% (BTS) and 10% (SSID).ConclusionInitial treatment of adults with CAP adhered closely with local guidelines was discordant with the BTS and SSID guidelines.
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