Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocol
Braz. j. infect. dis
;
17(5): 511-515, Sept.-Oct. 2013. tab
Article
in English
| LILACS
| ID: lil-689874
ABSTRACT
To assess the adequacy of medical prescriptions for community-acquired pneumonia at the emergency department of the Hospital de Clínicas de Porto Alegre, we conducted a prospective cohort study, from January through April 2011. All patients with suspected pneumonia were selected from the first prescription of antimicrobials held in the emergency room. Patients with a description of pneumonia, community-acquired pneumonia, respiratory infection, or other issues related to community-acquired pneumonia were selected for review. Two-hundred and fifteen patients were studied. Adherence to the hospital care protocol was 11.2% for the initial recommended tests (chest X-ray and collection of sputum sample), 34.4% for blood cultures, and 92.1% for the antimicrobial choice. Sixty percent of the prescriptions consisted of a combination of drugs, and the association of beta-lactam and macrolide was the most common. The Hospital Infection Control Committee evaluated patients' prescriptions within a median time of 23.5h (IQR 25-75%, 8-24). Negative evaluations accounted for 10% of prescriptions (n = 59). Fourteen percent of the patients died during hospitalization. In the multivariate analysis, Pneumonia Severity Index Score and use of ampicillin + sulbactam alone were independently related to in-hospital mortality. There was a high adherence to the hospital's CAP protocol, in relation to antimicrobial choice. Severity score and use of ampicillin + sulbactam alone were independently associated to in-hospital death.
Full text:
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Index:
LILACS (Americas)
Main subject:
Pneumonia, Bacterial
/
Guideline Adherence
Type of study:
Diagnostic study
/
Etiology study
/
Practice guideline
/
Incidence study
/
Observational study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. j. infect. dis
Journal subject:
Communicable Diseases
Year:
2013
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Hospital das Clínicas de Porto Alegre/BR
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