TY - JOUR T1 - International Guideline concordance of empiric antibiotic use in community-acquired pneumonia JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.4669 VL - 56 IS - suppl 64 SP - 4669 AU - Sergi Pascual Guardia AU - Judith Marin-Corral AU - Manuela Carugati AU - Stefano Aliberti AU - Oriol Sibila AU - Francisco Sanz AU - Giovanni Sotgiu AU - Pedro J. Marcos AU - Martin Kolditz AU - Marcos I. Restrepo Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/4669.abstract N2 - Community-acquired pneumonia (CAP) is the leading infectious cause of death worldwide and its empiric treatment is a critical decision. Several guidelines recommend the appropriate use of antibiotics for patients with CAP, but evidence regarding guideline concordance (GC) is limited to local or regional studies. Our aim was to evaluate the national and international GC of empiric antibiotic selection for 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 continental GC according to the recommendations by ERS-2011, ATS/IDSA-2007, and ALAT-2004, and by national guidelines from Portugal, United Kingdom, Pakistan, Spain, India, Germany and Croatia. We stratified the patients according to the site of care in ward or intensive care unit (ICU) admission.Results: We enrolled 3,019 patients with 83% admitted from the ward and 17% from the ICU. At a global level GC was 42%, highest in European countries according to the ERS-2011 (53%), followed by North America (35%) according to ATS/IDSA 2007 guidelines and 33% of South American countries according to ALAT-2004, respectively (p value <0.001 comparing all groups). National GC was higher in Portugal (71%) and Croatia (70%), but lowest in Pakistan (26%) and India (21%). GC therapy was higher among patients hospitalized in the ward service compared to the ICU.Conclusions: Adherence to CAP guidelines is suboptimal among the majority of participating countries or at the continental level. Antimicrobial stewardship programs should focus on improving adherence of empiric antibiotic selection in clinical practice.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4669.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.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). ER -