Cargando…

Impact of Guideline Adherence on Outcomes in Patients Hospitalized with Community-Acquired Pneumonia (CAP) in Hungary: A Retrospective Observational Study

Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. This retrospective observational study evaluated the antibiotic prescription patterns and associations between guideline adherence and outcomes in patients hospitalized with CAP in Hungary. Main outcome measu...

Descripción completa

Detalles Bibliográficos
Autores principales: Fésüs, Adina, Benkő, Ria, Matuz, Mária, Engi, Zsófia, Ruzsa, Roxána, Hambalek, Helga, Illés, Árpád, Kardos, Gábor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9026550/
https://www.ncbi.nlm.nih.gov/pubmed/35453219
http://dx.doi.org/10.3390/antibiotics11040468
_version_ 1784691149689061376
author Fésüs, Adina
Benkő, Ria
Matuz, Mária
Engi, Zsófia
Ruzsa, Roxána
Hambalek, Helga
Illés, Árpád
Kardos, Gábor
author_facet Fésüs, Adina
Benkő, Ria
Matuz, Mária
Engi, Zsófia
Ruzsa, Roxána
Hambalek, Helga
Illés, Árpád
Kardos, Gábor
author_sort Fésüs, Adina
collection PubMed
description Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. This retrospective observational study evaluated the antibiotic prescription patterns and associations between guideline adherence and outcomes in patients hospitalized with CAP in Hungary. Main outcome measures were adherence to national and international CAP guidelines (agent choice, dose) when using empirical antibiotics, antibiotic exposure, and clinical outcomes. Demographic and clinical characteristics of patients with CAP in the 30-day mortality and 30-day survival groups were compared. Fisher’s exact test and t-test were applied to compare categorical and continuous variables, respectively. Adherence to the national CAP guideline for initial empirical therapies was 30.61% (45/147) for agent choice and 88.89% (40/45) for dose. Average duration of antibiotic therapy for CAP was 7.13 ± 4.37 (mean ± SD) days, while average antibiotic consumption was 11.41 ± 8.59 DDD/patient (range 1–44.5). Adherence to national guideline led to a slightly lower 30-day mortality rate than guideline non-adherence (15.56% vs. 16.67%, p > 0.05). In patients aged ≥ 85 years, 30-day mortality was 3 times higher than in those aged 65–84 years (30.43% vs. 11.11%). A significant difference was found between 30-day non-survivors and 30-day survivors regarding the average CRP values on admission (177.28 ± 118.94 vs. 112.88 ± 93.47 mg/L, respectively, p = 0.006) and CCI score (5.71 ± 1.85 and 4.67 ± 1.83, p = 0.012). We found poor adherence to the national and international CAP guidelines in terms of agent choice. In addition, high CRP values on admission were markedly associated with higher mortality in CAP.
format Online
Article
Text
id pubmed-9026550
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-90265502022-04-23 Impact of Guideline Adherence on Outcomes in Patients Hospitalized with Community-Acquired Pneumonia (CAP) in Hungary: A Retrospective Observational Study Fésüs, Adina Benkő, Ria Matuz, Mária Engi, Zsófia Ruzsa, Roxána Hambalek, Helga Illés, Árpád Kardos, Gábor Antibiotics (Basel) Article Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. This retrospective observational study evaluated the antibiotic prescription patterns and associations between guideline adherence and outcomes in patients hospitalized with CAP in Hungary. Main outcome measures were adherence to national and international CAP guidelines (agent choice, dose) when using empirical antibiotics, antibiotic exposure, and clinical outcomes. Demographic and clinical characteristics of patients with CAP in the 30-day mortality and 30-day survival groups were compared. Fisher’s exact test and t-test were applied to compare categorical and continuous variables, respectively. Adherence to the national CAP guideline for initial empirical therapies was 30.61% (45/147) for agent choice and 88.89% (40/45) for dose. Average duration of antibiotic therapy for CAP was 7.13 ± 4.37 (mean ± SD) days, while average antibiotic consumption was 11.41 ± 8.59 DDD/patient (range 1–44.5). Adherence to national guideline led to a slightly lower 30-day mortality rate than guideline non-adherence (15.56% vs. 16.67%, p > 0.05). In patients aged ≥ 85 years, 30-day mortality was 3 times higher than in those aged 65–84 years (30.43% vs. 11.11%). A significant difference was found between 30-day non-survivors and 30-day survivors regarding the average CRP values on admission (177.28 ± 118.94 vs. 112.88 ± 93.47 mg/L, respectively, p = 0.006) and CCI score (5.71 ± 1.85 and 4.67 ± 1.83, p = 0.012). We found poor adherence to the national and international CAP guidelines in terms of agent choice. In addition, high CRP values on admission were markedly associated with higher mortality in CAP. MDPI 2022-03-30 /pmc/articles/PMC9026550/ /pubmed/35453219 http://dx.doi.org/10.3390/antibiotics11040468 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fésüs, Adina
Benkő, Ria
Matuz, Mária
Engi, Zsófia
Ruzsa, Roxána
Hambalek, Helga
Illés, Árpád
Kardos, Gábor
Impact of Guideline Adherence on Outcomes in Patients Hospitalized with Community-Acquired Pneumonia (CAP) in Hungary: A Retrospective Observational Study
title Impact of Guideline Adherence on Outcomes in Patients Hospitalized with Community-Acquired Pneumonia (CAP) in Hungary: A Retrospective Observational Study
title_full Impact of Guideline Adherence on Outcomes in Patients Hospitalized with Community-Acquired Pneumonia (CAP) in Hungary: A Retrospective Observational Study
title_fullStr Impact of Guideline Adherence on Outcomes in Patients Hospitalized with Community-Acquired Pneumonia (CAP) in Hungary: A Retrospective Observational Study
title_full_unstemmed Impact of Guideline Adherence on Outcomes in Patients Hospitalized with Community-Acquired Pneumonia (CAP) in Hungary: A Retrospective Observational Study
title_short Impact of Guideline Adherence on Outcomes in Patients Hospitalized with Community-Acquired Pneumonia (CAP) in Hungary: A Retrospective Observational Study
title_sort impact of guideline adherence on outcomes in patients hospitalized with community-acquired pneumonia (cap) in hungary: a retrospective observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9026550/
https://www.ncbi.nlm.nih.gov/pubmed/35453219
http://dx.doi.org/10.3390/antibiotics11040468
work_keys_str_mv AT fesusadina impactofguidelineadherenceonoutcomesinpatientshospitalizedwithcommunityacquiredpneumoniacapinhungaryaretrospectiveobservationalstudy
AT benkoria impactofguidelineadherenceonoutcomesinpatientshospitalizedwithcommunityacquiredpneumoniacapinhungaryaretrospectiveobservationalstudy
AT matuzmaria impactofguidelineadherenceonoutcomesinpatientshospitalizedwithcommunityacquiredpneumoniacapinhungaryaretrospectiveobservationalstudy
AT engizsofia impactofguidelineadherenceonoutcomesinpatientshospitalizedwithcommunityacquiredpneumoniacapinhungaryaretrospectiveobservationalstudy
AT ruzsaroxana impactofguidelineadherenceonoutcomesinpatientshospitalizedwithcommunityacquiredpneumoniacapinhungaryaretrospectiveobservationalstudy
AT hambalekhelga impactofguidelineadherenceonoutcomesinpatientshospitalizedwithcommunityacquiredpneumoniacapinhungaryaretrospectiveobservationalstudy
AT illesarpad impactofguidelineadherenceonoutcomesinpatientshospitalizedwithcommunityacquiredpneumoniacapinhungaryaretrospectiveobservationalstudy
AT kardosgabor impactofguidelineadherenceonoutcomesinpatientshospitalizedwithcommunityacquiredpneumoniacapinhungaryaretrospectiveobservationalstudy