RT Journal Article
SR Electronic
T1 Management of community acquired pneumonia (CAP) in a UK district general hospital (DGH)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2458
VO 40
IS Suppl 56
A1 Usman Maqsood
A1 Nawaid Ahmad
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P2458.abstract
AB BackgroundAlthough there are published BTS guidelines [Thorax 2009;64(Suppl III)] for the management of CAP; its practice across UK hospitals is variable and at times lacking; in achieving satisfactory outcomes.ObjectivesTo audit the management of patients admitted with CAP in a UK DGH.MethodA retrospective audit was undertaken between the periods covering 01/10/2010-31/08/2011. We included all patients admitted through the emergency or community referral system with a radiological diagnosis of pneumonia. We excluded patients who were immunocomprised or under 16 years of age.ResultsA total of 56 patients (59% female; n=33) were included. CURB-65 score was documented in 20% (n=11). With regards to anti-microbial treatment, 12.7% (n=7) patients were given B-lactam alone, 76.3% (n=42) were given B-lactam + Macrolide, 10.9% (n=6) were given Levofloxacin and one patient each received either Metronidazole or gentamycin. Time between diagnosis and first dose of antibiotic was greater than 4 hours in 57.3% (n=32) patients. 27% (n=15) patients received antibiotics against the published local guidelines (local guidelines followed BTS guidelines).Total length of stay varied from 0-101 days with a median of 7.5 days. There were 6 deaths within 30 days of discharge, of which 2 died on admission.ConclusionsDespite guidelines, there was poor documentation and recognition of the severity of CAP. There was deviation from recommended prescribing, hence risking emergence of resistant strains. Many patients received antibiotics beyond the recommended time window. Therefore, hospitals need to make sure that guidelines are being followed, in order to achieve further reduction in morbidity and mortality.