Abstract

Background: Adequate and immediate empiric antibiotic treatment improves the outcome of community-acquired pneumonia (CAP). Using the antibiotic regulation guidelines of the Bureau of National Health Insurance, we examined the impact of initial antibiotic choice on the outcome of CAP. Methods and patients: In this study, we retrospectively reviewed patients with CAP (modified Fine risk classes II, Ill and IV) who were hospitalized in Taichung Veterans General Hospital in 2002. We assessed the outcome parameters, including total hospital costs, length of hospital stay (LOS), and in-hospital survival rate. We compared the outcome parameters of 2 groups: the line antibiotics (1(superscript st) ATB) group and the 2(superscript nd) line antibiotics (2(superscript nd) ATB) group. Results: A total of 116 patients were enrolled in the study. Compared to the 1(superscript st) ATB group, the 2(superscript nd) ATB group had a longer length of stay (Mann-Whitney U test, p=0.008) and higher hospital costs (Mann-Whitney U test, p=0.0004), but no significant difference in survival rate (log-rank test, p=0.662). Conclusion: The 2(superscript nd) ATB group did not demonstrate a better outcome. This was probably due to the difference in disease severity.

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