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Appropriate antibiotic utilization in seniors prior to hospitalization for community‐acquired pneumonia is associated with decreased in‐hospital mortality
Author(s) -
Johnson D.,
Carriere K. C.,
Jin Y.,
Marrie T.
Publication year - 2004
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.2004.00553.x
Subject(s) - medicine , medical prescription , antibiotics , pneumonia , odds ratio , community acquired pneumonia , emergency medicine , intensive care medicine , pediatrics , microbiology and biotechnology , pharmacology , biology
Summary Background: We analysed the association of mortality and prescription of antibiotics prior to hospitalization for community‐acquired pneumonia. Methods: We used administrative data (hospital abstracts, physician claims, prescriptions) for seniors (age 61 years and over) for Alberta, Canada from 1 April 1994 to 31 March 1999. Results: Hospitalization of 21 191 seniors occurred during the study period. In about 43% of hospitalizations ( n = 9034), a physician was consulted prior to hospital admission. Antibiotics were dispensed to 31% of those with a prior physician visit and in about 72%, the antibiotic choice was deemed appropriate. The odds for mortality were significantly decreased in those with prior physician visits (OR = 0·87, P < 0·01), with any antibiotic prescription (OR = 0·66, P < 0·0001), and with an appropriate antibiotic (OR = 0·68, P = 0·03). The choice of an appropriate antibiotic as opposed to an inappropriate antibiotic resulted in a 2·6% absolute and 38% relative mortality reduction. Conclusion: Choosing an appropriate outpatient antibiotic in accordance with published expert opinion guidelines compared with inappropriate antibiotic prescriptions decreased hospital mortality in patients subsequently hospitalized for community‐acquired pneumonia.