Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocol
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 presc...
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| Format: | Article |
| Language: | English |
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Elsevier
2013-09-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S141386701300144X |
| _version_ | 1818500561537859584 |
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| author | Clei Angelo Mocelin Rodrigo Pires dos Santos |
| author_facet | Clei Angelo Mocelin Rodrigo Pires dos Santos |
| author_sort | Clei Angelo Mocelin |
| collection | DOAJ |
| description | 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 23.5 h (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. Keywords: Pneumonia, Community, Treatment |
| first_indexed | 2024-12-10T20:44:26Z |
| format | Article |
| id | doaj.art-af1319d4c6b34452be450ce35f652714 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-10T20:44:26Z |
| publishDate | 2013-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-af1319d4c6b34452be450ce35f6527142022-12-22T01:34:17ZengElsevierBrazilian Journal of Infectious Diseases1413-86702013-09-01175511515Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocolClei Angelo Mocelin0Rodrigo Pires dos Santos1Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Corresponding author at: Hospital das Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil.Infection Control Committee, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, BrazilTo 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 23.5 h (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. Keywords: Pneumonia, Community, Treatmenthttp://www.sciencedirect.com/science/article/pii/S141386701300144X |
| spellingShingle | Clei Angelo Mocelin Rodrigo Pires dos Santos Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocol Brazilian Journal of Infectious Diseases |
| title | Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocol |
| title_full | Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocol |
| title_fullStr | Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocol |
| title_full_unstemmed | Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocol |
| title_short | Community-acquired pneumonia at the Hospital de Clínicas de Porto Alegre: evaluation of a care protocol |
| title_sort | community acquired pneumonia at the hospital de clinicas de porto alegre evaluation of a care protocol |
| url | http://www.sciencedirect.com/science/article/pii/S141386701300144X |
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