1. Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocol.
- Author
-
Mocelin CA and dos Santos RP
- Subjects
- Aged, Anti-Bacterial Agents administration & dosage, Cohort Studies, Community-Acquired Infections diagnosis, Community-Acquired Infections drug therapy, Community-Acquired Infections mortality, Female, Hospital Mortality, Humans, Male, Middle Aged, Pneumonia, Bacterial diagnosis, Pneumonia, Bacterial mortality, Prospective Studies, Severity of Illness Index, Guideline Adherence, Pneumonia, Bacterial drug therapy
- Abstract
To assess the adequacy of medical prescriptions for community-acquired pneumonia at the emergency department of the Hospital de Clínicas de Porto Alegre, we conducted a prospective cohort study, from January through April 2011. All patients with suspected pneumonia were selected from the first prescription of antimicrobials held in the emergency room. Patients with a description of pneumonia, community-acquired pneumonia, respiratory infection, or other issues related to community-acquired pneumonia were selected for review. Two-hundred and fifteen patients were studied. Adherence to the hospital care protocol was: 11.2% for the initial recommended tests (chest X-ray and collection of sputum sample), 34.4% for blood cultures, and 92.1% for the antimicrobial choice. Sixty percent of the prescriptions consisted of a combination of drugs, and the association of beta-lactam and macrolide was the most common. The Hospital Infection Control Committee evaluated patients' prescriptions within a median time of 23.5h (IQR 25-75%, 8-24). Negative evaluations accounted for 10% of prescriptions (n=59). Fourteen percent of the patients died during hospitalization. In the multivariate analysis, Pneumonia Severity Index Score and use of ampicillin+sulbactam alone were independently related to in-hospital mortality. There was a high adherence to the hospital's CAP protocol, in relation to antimicrobial choice. Severity score and use of ampicillin+sulbactam alone were independently associated to in-hospital death., (Copyright © 2013 Elsevier Editora Ltda. All rights reserved.)
- Published
- 2013
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