Community-acquired Pneumonia in Elderly: Comparison of Clinical Manifestations and Causative Organisms before and after the Separation of Prescription and Drug-Selling / 감염과화학요법

ABSTRACT

INTRODUCTION: Community-acquired pneumonia is a common infectious disease in the elderly patients with high mortality. We studied to see if there were any differences in clinical manifestations and etiologies, and antibiotic-resistance in etiologic pathogens before and after the Separation of Prescription and Drug-selling. METHODS: We reviewed medical records of the elderly patients (> or =65 years-old of age) with CAP who visited Korea University Guro hospital. 119 patients (from Jan. 1994 to Dec. 1997) before the separation and 107 patients (from Dec. 2000 to Aug. 2003) after the separation were reviewed. Clinical manifestations, etiologies, and antibiotic resistance of pathogens were compared. RESULTS: The percentage of patients who has taken some antibiotics before coming to our hospital decreased after the Separation of Prescription and Drug-Selling. There were no differences in symptoms except for altered mental status which were more common before the separation. The average duration of hospital stay, complications and mortality showed no significant differences. S. pneumoniae, S. aureus, and K. pneumoniae were the main pathogens in both groups. Antibiotic susceptibility test results of S. pneumoniae, K. pneumoniae, P. aeruginosa were compared. Resistant pathogens were somewhat decreased after the Separation but there was no statistical significance. CONCLUSION: After the separation of Prescription and Drug-Selling, antibiotic use among elderly CAP patients before coming to the hospital decreased. Causative organisms were not changed. Antibiotic resistance improved a little but there was no statistical significance.