To the Editor:
Community-acquired pneumonia (CAP) is a major respiratory health disease with high prevalence in the general population, clinical heterogeneity and different degrees of severity. In both the USA and Europe, CAP is the most frequent cause of infection-related death. Its incidence varies from country to country and from study to study, and it is higher in very young children and elderly persons [1]. A recent UK study documented an increase of 34% in hospital admissions due to CAP over the past decade [2].
Despite the importance of its social impact, actual incidence of CAP in different settings is still under scrutiny. Thus, we aimed to explore the epidemiology of CAP in Italian general practice.
We collected data from the Health Search - CSD Patient Database (HSD), an electronic general practice database, representative of the Italian general population, which was set up in 1998 by the Italian College of General Practitioners (Florence, Italy). The HSD contains data from approximately 1.2 million inhabitants under the care of 800 general practitioners (GPs), homogenously distributed across Italy. All clinical diagnoses are coded according to the International Classification of Diseases 9th Revision (ICD-9). Drugs are coded according to the Anatomical Therapeutic and Chemical classification system. The HSD has been extensively used for pharmaco-epidemiologic research [3].
Patients recruited between January 1, 2005 and December 31, 2009 were eligible if aged ≥15 years with clinical records in the database spanning a minimum duration of 2 years and an ICD-9-based incident diagnosis of CAP. The first date of CAP diagnosis was defined as …