Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia.

Rossio, R; Franchi, C; Ardoino, I; Djade, C; Tettamanti, M; Pasina, L; Salerno, F; Marengoni, A; Corrao, S; Marcucci, M; Peyvandi, F; Biganzoli, E; Nobili, A; Mannucci, P

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Abstract

Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of anti-biotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriat-ric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumo-nia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggest-ing the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia.
Lingua originaleEnglish
pagine (da-a)330-337
Numero di pagine8
RivistaEuropean Journal of Internal Medicine
Volume26
Stato di pubblicazionePublished - 2015

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All Science Journal Classification (ASJC) codes

  • Internal Medicine

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Rossio, R; Franchi, C; Ardoino, I; Djade, C; Tettamanti, M; Pasina, L; Salerno, F; Marengoni, A; Corrao, S; Marcucci, M; Peyvandi, F; Biganzoli, E; Nobili, A; Mannucci, P (2015). Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia. European Journal of Internal Medicine, 26, 330-337.