Source: International Congress 2014 – Different interesting issues in respiratory infections: 1
Disease area: Respiratory infections

Abstract

BACKGROUND: The compliance of Greek chest physicians with practice guidelines for CAP and its impact on cost and patients' outcome remain unknown.MATERIAL & METHOD: A prospective observational study incorporating 250 immunocompetent hospitalized pts with CAP. The aim was to investigate whether the 2007 IDSA/ATS and the Greek national guidelines for CAP are implemented by chest physicians in “Sotiria” hospital, Athens. We: a) assessed whether the decision of hospital admission was correct or not and b) evaluated whether the administered antimicrobial regimen was in accordance to guidelines. Fine score (PSI) was applied by the authors to determine the severity of CAP. 161 pts were male and 89 female. Comorbidities presented in 173 pts.RESULTS: The mortality rate was 12.8%. A microbial pathogen was identified in 55 (22%) cases and Streptococcus pn. was the predominant pathogen isolated (38.46%). COPD pts performed a strong trend towards higher mortality compared to non COPD pts (22.73% vs 10.68% respectively, p=0.055). Implementation of CAP guidelines as far as the initial antimicrobial regimen is concerned was poor (149 pts, 59.6%). Patients treated with an initial antimicrobial in accordance to guidelines, performed a trend towards lower mortality and shorter LOS, compared to those in discordance to guidelines (p=0.078 & p=0.062). 120 (48%) pts were admitted to the hospital, despite they were classified as risk class I or II and therefore could be treated as outpatients.CONCLUSION: The implementation of CAP guidelines by Greek chest physicians is poor. Improvement of adherence may improve patients' outcome, shorten the LOS and reduce the financial burden for the national health system.

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C. Triantafyllidis, V. Kapordelis, E. C. Filippidou, M. Apostolidou, G. Papaetis, D. Orfanidou, I. Nikolopoulos, A. Pefanis (Athens, Kavala, Greece). The compliance of Greek chest physicians with IDSA/ATS and the Greek national guidelines for CAP. Eur Respir J 2014; 44: Suppl. 58, 2561

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