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

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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 antibiotic 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 geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia 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, suggesting 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
RivistaDefault journal
Volume26
Stato di pubblicazionePublished - 2015

All Science Journal Classification (ASJC) codes

  • Internal Medicine

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@article{4131a4be038f4e28817f6837039ac5d5,
title = "Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia",
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 antibiotic 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 geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia 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, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia.",
keywords = "80 and over; Anti-Bacterial Agents; Female; Hospital Mortality; Humans; Logistic Models; Male; Pneumonia; Practice Guidelines as Topic; Treatment Outcome; Guideline Adherence; Hospitalization; Internal Medicine, Antibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalization; Age Factors; Aged; Aged",
author = "{Dominguez Rodriguez}, {Ligia Juliana} and Pasquale Mansueto and Mario Barbagallo and Salvatore Corrao and Daniela D'Angelo and Lidia Plances",
year = "2015",
language = "English",
volume = "26",
pages = "330--337",
journal = "Default journal",

}

TY - JOUR

T1 - Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

AU - Dominguez Rodriguez, Ligia Juliana

AU - Mansueto, Pasquale

AU - Barbagallo, Mario

AU - Corrao, Salvatore

AU - D'Angelo, Daniela

AU - Plances, Lidia

PY - 2015

Y1 - 2015

N2 - 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 antibiotic 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 geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia 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, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia.

AB - 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 antibiotic 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 geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia 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, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia.

KW - 80 and over; Anti-Bacterial Agents; Female; Hospital Mortality; Humans; Logistic Models; Male; Pneumonia; Practice Guidelines as Topic; Treatment Outcome; Guideline Adherence; Hospitalization; Internal Medicine

KW - Antibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalization; Age Factors; Aged; Aged

UR - http://hdl.handle.net/10447/297915

UR - http://www.elsevier.com/locate/ejim

M3 - Article

VL - 26

SP - 330

EP - 337

JO - Default journal

JF - Default journal

ER -