Estudio de las infecciones respiratorias en el adulto ingresado en servicios de medicina interna y neumología. Estudio DIRA

Abstract

Respiratory tract infections (RIs) are frequent processes that can require hospitalization or affect already hospitalized patients. The Foundation for the Study of Infection has promoted the DIRA (Adult Respiratory Infection Day) Project, with the aim of investigating and assessing the impact of this problem, particularly in Internal Medicine and Pneumology Departments. Prospective prevalence study involving 158 physicians in 100 Internal Medicine and Pneumology Departments. Data were collected on predetermined days, once every three months (total of four data sets) and included information on number of patients attended, number of patients with infection, and epidemiologic, clinical, microbiologic and treatment characteristics of patients with RI. A total of 3,596 patients were hospitalized at the four time points. Among these, 39.1% presented clinical symptoms consistent with infection and 34.3% of these were RIs. The mean age of RI patients was 65.6 years, 68.8% were males, 84.1% had an underlying disease (most frequently chronic obstructive pulmonary disease) and 25.1% had one or more predisposing factors. Pneumonia was the most frequent diagnosis (41.3% of RIs). RI was documented microbiologically in 15.8% of cases. Antibiotic treatment was applied in 99.7% of patients with acute bronchitis and 81.8% of those with upper respiratory tract infection; penicillins were the most frequent treatment. Data are presented by diagnosis. A substantial rate of respiratory infections was found in patients admitted to hospital Internal Medicine and Pneumology Departments, with pneumonia being the most frequent. There was a paucity of microbiologic documentation. It is likely that antibiotic treatment was not justified in the majority of patients with upper respiratory tract infections. A combination of two or more antimicrobial agents was used in about half of cases.