Abstract
Antibiotic guidelines have been published by various societies indicating the optimal empiric antibiotic treatment of patients with community acquired pneumonia (CAP); however, no studies have been undertaken in South Africa investigating whether the most recent South African Thoracic Society (SATS) antibiotic CAP guideline, published in 2007, is being adhered to, or whether adherence is associated with improved patient outcomes. This was a retrospective record review over a one-year period undertaken to document levels of adherence to the 2007 SATS guideline for CAP management in adults at an academic teaching hospital. A total of 181 patients with CAP were included in the study, of whom 101 were female, and 109 were known to be HIV-seropositive. The majority (66%) of the patients received antibiotic treatment that was guideline-adherent. In those patients who received treatment that was non-adherent to the guideline recommendations, rather than receiving inadequate cover, they actually had received treatment that was in excess of what was recommended. There was no significant difference in the length of hospital stay among the two patient groups; however, a significantly longer time to clinical stability was found in patients who had received guideline-adherent treatment.Only one CAP patient died and therefore it was not possible to determine the impact of guideline adherence on patient mortality. Results of this study indicated a relatively high level of SATS guideline adherence. Guideline adherence was not associated with improved patient outcomes.
Highlights
Antibiotic guidelines have been published by various societies indicating the optimal empiric antibiotic treatment of patients with community acquired pneumonia (CAP); no studies have been undertaken in South Africa investigating whether the most recent South African Thoracic Society (SATS) antibiotic CAP guideline, published in 2007, is being adhered to, or whether adherence is associated with improved patient outcomes
This study was designed and implemented to document the levels of adherence to the most recently (2007) published South Africa Thoracic Society CAP guideline [2], with regard to the choice of initial empiric antibiotic therapy, and to determine if adherence to the guideline recommendations was associated with improved outcomes in patients hospitalized with CAP
Antibiotic regimens The majority of patients (66%) were found to have received treatment that was adherent to the SATS guideline
Summary
Community acquired pneumonia (CAP) is one of the diseases with the greatest morbidity and mortality in the world, and leads to substantial consumption of healthcare resources. Neither symptoms nor routine laboratory or radiological findings allow an accurate aetiological diagnosis [2] For all these reasons, numerous CAP guidelines have been published by various national and international societies [3], including the South African Thoracic Society [2], which have recommendations for both overall patient management, as well as the choice of initial empiric antibiotic therapy. This study was designed and implemented to document the levels of adherence to the most recently (2007) published South Africa Thoracic Society CAP guideline [2], with regard to the choice of initial empiric antibiotic therapy, and to determine if adherence to the guideline recommendations was associated with improved outcomes in patients hospitalized with CAP
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