Prevalence of Clinical Signs Within Reference Ranges Among Hospitalized Patients Prescribed Antibiotics for Pneumonia

Key Points Question What is the prevalence of antibiotic therapy for possible pneumonia in hospitalized patients despite clinical signs within the reference range? Findings In this cohort study of 12 273 patients treated for possible pneumonia in 4 hospitals, all cardinal signs for pneumonia were within reference ranges in 18.6% of patients with possible community-acquired pneumonia and 13.5% of patients with possible hospital-acquired pneumonia. Antibiotics were continued for 3 days or longer after all clinical signs were normal in 34.8% of patients treated for community-acquired pneumonia and 38.4% treated for hospital-acquired pneumonia. Meaning Findings of this study suggest that antibiotics are prescribed frequently for suspected pneumonia in patients with clinical signs within reference ranges and continued for 3 days or longer after clinical signs normalize; these findings suggest potential targets to improve prescribing.