Antimicrobial management in community acquired pneumonia in hospital at home: Is there room for improvement?
| Autor: | David Sánchez Fabra, Raúl Martínez Murgui, Isabel Fiteni Mera, Adriana Ger Buil, Teresa Rubio Obanos, Marta Teresa Matía Sanz, Isabel Torres Courchoud |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.drug_class Common disease 030106 microbiology Antibiotics Poor quality 03 medical and health sciences 0302 clinical medicine Community-acquired pneumonia medicine Antimicrobial stewardship Humans 030212 general & internal medicine Medical prescription Retrospective Studies business.industry Pneumonia medicine.disease Antimicrobial Hospitals Anti-Bacterial Agents Clinical Practice Community-Acquired Infections Emergency medicine business |
| Zdroj: | Enfermedades infecciosas y microbiologia clinica (English ed.). 39(6) |
| ISSN: | 2529-993X |
| Popis: | Introduction Community Acquired Pneumonia (CAP) is common disease that can be treated in Hospital At Home (HAH). In this paper we evaluate the room of improvement in the use of antibiotics in CAP in HH. Methods Patients with CAP were retrospectively recruited in two Spanish hospitals from 1/1/18 to 10/30/19. Demographic, clinical and quality of antibiotic prescription variables were recorded. Subsequently, we created a new variable that collected six quality of care indicator, categorizing and comparing patients into two groups: good quality of care (4 or more indicators performed) or poor quality of care (3 or less indicators performed). Results We recruited 260 patients. The request for diagnostic tests and the adequacy to Clinical Practice Guidelines were 85.4% and 85.8% respectively. Percentages of de-escalation (53.7%) and sequential therapy (57.7%) when indicated were low. The average length of treatment was 7.3 days for intravenous and 9.5 days for total. Quality of prescription was good in 134 (63.2%) patients, being more frequent in those who were admitted directly to HAD from the emergency room. It was also associated with less readmission at 30 days. Conclusion There is a wide room for improvement in some fields of antimicrobials use in HAH that could stimulate the implementation of Antimicrobial Stewardship Programs. |
| Databáze: | OpenAIRE |
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