Chest
Special ReportUse of Guidelines in Treating Community-Acquired Pneumonia
Section snippets
MATERIALS AND METHODS
The study setting is a 1, 100-bed, two-campus, tertiary-care teaching hospital (The Toronto Hospital). Inpatient medical care is provided by teams of housestaff, each of one second- or third-year (senior) medical resident, two first-year residents, and two medical students. General medical patients admitted to this institution are referred by the emergency physician to the on-call housestaff. They are assessed for hospital admission by one of the housestaff members, and initial treatment plans
RESULTS
Two hundred fifty-five eligible patients were admitted to the hospital over the study period. One hundred twenty-two (48%) had questionnaires completed prospectively by housestaff, and 130 of the remaining 133 had their charts reviewed retrospectively (3 charts could not be located). Data on 252 patients were therefore available for analysis. Demographic, comorbidity, and guidelines adherence data comparing the two groups are summarized in Table 1. There were no significant differences in sex
DISCUSSION
This study, which assessed the utilization of the ATS/CIDS/CTS guidelines for empiric treatment of CAP at a tertiary-care center, provides some insight into how the guidelines might be usefully modified and also attempts to address their effects on clinical outcome. The only similar published study of which we are aware studied outpatients and did not assess reasons for guidelines deviation.17
We found the guidelines to be widely used in our institution, with similar adherence rates of 81% and
ACKNOWLEDGMENTS
We wish to thank Drs. Moira Kapral and Howard Leong-Poi, all the attending staff in the Clinical Teaching Units and housestaff at the Toronto Hospital during the academic year 1995 to 1996 for making this project possible.
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