Source: Annual Congress 2001 - Community-acquired pneumonia: from diagnosis to discharge
Disease area: Respiratory infections

Abstract

Objective. To evaluate the effect of the implementation of ERS-guidelines on routine management of adult community-acquired pneumonia (CAP) in a primary care hospital.
Methods. In period I, routine management prior to any intervention was documented. In period II, ERS guidelines were implemented. Management was evaluated with regard to the following endpoints: patient characteristics, severity of pneumonia, appropriateness of antimicrobial treatment, length of hospitalization, treatment failures, and death.
Results. Overall 232 patients were included in period I and 116 in period II. The distribution of mild, moderate, and severe pneumonia was as follows: 24% vs 15% (p <0.001), 67% vs 68% (p = ns), and 9% vs 17% (p <0.05). The rate of treatment failures was not different (21% vs 19%) but mortality was significantly higher in period II (7% vs 15%, p < 0.05). Inadequate antimicrobial treatment as well as overtreatment rates could be significanty reduced (27% vs 16%, p < 0.05 and 46% vs 11%, p <0.0001). Mean hospitalization times were significantly lower in period II (14.8 vs 13.0 days, p < 0.0001). This was also true across all risk classes according to Fine and coworkers, except for class V.
Conclusions. After implementation of ERS guidelines, significantly less patients with mild and more with severe pneumonia were hospitalized, the rates for inadequate antimicrobial treatment and overtreatment were significantly lower, and hospitalization times could be reduced by approximately two days. Thus,ERS-guidelines contributed significantly to an improved management approach of patients with CAP.

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Citations should be made in the following way:
S. Ewig, M. Schlochtermeier, N. Göke, H. Schäfer (Bonn, Wesseling, Saarbrücken, Germany). Implementation of ERS guidelines for the management of adult community-acquired pneumonia in a primary care hospital. Eur Respir J 2001; 16: Suppl. 31, 3393

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