01 September 2005
Treatment of community-acquired pneumonia: a descriptive study in an Apulian department of internal medicine.
Gianluigi Giannelli, Laura Minchella, Pier Luigi Lopalco, Grazia Mastromarco, Salvatore AntonaciMed Sci Monit 2005; 11(9): CR434-439 :: ID: 428452
Abstract
Background: Infections of the lower airways pose a serious problem forthe health service, both because of the burden of the disease and because of the large number of resourcesthat need to be devoted to treating it. Material/Methods: The present study describes the use of antibioticsto treat acute bronchopneumonia in the Internal Medicine Department "Cesare Frugoni" of a universityhospital in southern Italy. A total of 493 patients were studied during a 4.5-year period. Results: In98.2% of cases an empirical approach to treatment was adopted, and only in 57 patients was targeted treatmentadministered. Mean duration of the antibiotic therapy was 11.3 days, with a wide range. Assessment ofprognosis in the different groups showed that this did not seem to depend on the type of treatment approachor on the type and/or number of antibiotics used. Instead, targeted therapy was correlated with a shorterduration of treatment. Blood culture was very rarely carried out. The almost invariably empirical approachto treatment of bronchopneumonia infections resulted in longer hospital stay and a greater consumptionof antibiotics, often of latest generation. Conclusions: Therefore, more studies would be useful to investigatethe real adherence to the guidelines in the clinical practice. Finally, blood culture should be performedroutinely in these patients, although the time required for the test could be a limiting factor.
Keywords: Anti-Bacterial Agents - therapeutic use, Bronchopneumonia - drug therapy, Community-Acquired Infections - drug therapy, Drug Administration Schedule, Hospital Departments, Hospitals, University, Internal Medicine, Italy, Pneumonia, Bacterial - drug therapy
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