Treatment Trends and Outcomes in Healthcare-Associated Pneumonia

Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine
Sarah HaesslerMichael B Rothberg

Abstract

The American Thoracic Society and Infectious Diseases Society of America guidelines for management of healthcare-associated pneumonia (HCAP), first published in 2005, have been controversial regarding the selection of empiric broad-spectrum antibiotics, whether the criteria for HCAP predicts the likelihood of infection with multidrug resistant organisms, and whether HCAP patients have improved outcomes when treated with empiric broad-spectrum antibiotics. A retrospective cohort study at 488 US hospitals from July 2007 to November 2011. Patients who met criteria for HCAP were included. Guideline-concordant antibiotics were assessed based on guideline recommendations. We assessed changes in hospital rates of concordant antibiotic use over time and their correlation with outcomes. Among 149,963 patients with HCAP, 19.6% received fully guideline-concordant antibiotics, 21.7% received partially concordant antibiotics, and 58.9% received discordant antibiotics. Guideline concordance increased over time. Rates of fully or partially concordant antibiotics varied across hospitals (median 36.4%; interquartile range 25.8%-49.1%). Among patients who received discordant antibiotics, 81.5% were treated according to community-acquired pneumon...Continue Reading

Citations

Feb 25, 2018·Antimicrobial Agents and Chemotherapy·Brandon J WebbNathan C Dean
Apr 27, 2019·The European Respiratory Journal·Brandon J WebbNathan C Dean
Oct 7, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jennifer J SchimmelMichael B Rothberg
Jul 11, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Abhishek Deshpande, Michael B Rothberg

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