Abstract
Community-acquired pneumonia (CAP) guidelines recommend appropriate antibiotics use depending on the different risk factors. However, evidence regarding the guideline adherence (GA) on this topic is limited. Our aim was to evaluate the GA of empiric antibiotic selection regarding risk factors in hospitalized patients with CAP.
Methods: We used the platform of an international, multicenter, point-prevalence study of hospitalized immunocompetent patients with CAP. We analyzed the risk factors and the GA according to the recommendations by ERS-2011, ATS/IDSA-2007 and 2019.
Results: We enrolled 3.019 patients. At a global level, adherence with ERS-2011 and ATS/IDSA 2007 and 2019 guidelines were 49%, 34% and 34% respectively. Adherence to at least one of the three guidelines was 51% (1545 cases). Following risk factors were significantly associated with worst GA (OR[95% of CI]): Bedridden (1.4[1.2-1.8]), Chronic aspiration (2.0[1.5-2.6]), Nursing home residence (1.4[1.1-1.9]), Bronchiectasis (2.4[1.7-3.3]), Chronic obstructive pulmonary disease (COPD) (1.3[1.1-1.5]), Interstitial lung disease (1.8[1.1-3.0]), Home O2 use (1.9[1.4-2.6]), Steroids use (1.4[1.0-1.9), prior Methicillin-resistant Staphylococcus aureus (MRSA) isolation ([1.9[1.1-2.9]), prior Extended-spectrum beta-lactamases (ESBL) isolation (2.6[1.3-5.2]) and prior Pseudomonas isolation (3.8[2.2-6.7]). Asthma and HIV were associated with better GA (0.7[0.5-0.9] and 0.3[0.2-0.6] respectively).
Conclusions: Adherence to CAP guidelines was suboptimal in participating countries. Empirical antimicrobial use programs should focus on improving guidelines adherence, especially in patients with specific risk factors.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 4255.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
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