Reasons for Coming to Hospital after Treatment for Community-Acquired Pneumonia on an Ambulatory Basis

Abstract

Most patients with community-acquired pneumonia (CAP) are treated on an ambulatory basis. To evaluate the reasons for presentation to hospital after treatment for CAP on an ambulatory basis. The study, conducted in five hospitals in the Capital Health Region (Edmonton, Alberta), enrolled adult patients aged 17 years or older who presented with a history of having been diagnosed and treated for pneumonia within the previous month. A current diagnosis of pneumonia was based on two or more symptoms or signs of CAP, plus radiographic evidence of pneumonia. Seventy-five (77.3%) of the 97 patients who met the inclusion criteria had CAP, and 22 (22.7%) patients presented with a noninfectious illness. Of the patients with CAP, 25 (33.3%) met the study criteria for worsening of a comorbid illness, 23 (30.7%) had clinical failure, 16 (21.3%) had microbiological failure, six (8.0%) were noncompliant, four (5.3%) had failure of expectations and one (1.3%) had adverse effects of antimicrobial therapy. Underlying diseases, exacerbations of comorbidities and complications of CAP, as well as confounders such as unusual infections and noninfectious conditions that mimic CAP, are all reasons for presenting to hospital after treatment for CAP in an ambulatory setting.