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The efficacy of an antibiotic protocol for community‐acquired pneumonia
Author(s) -
Dobbin Catherine J,
Duggan Christopher J,
Barnes David J
Publication year - 2001
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2001.tb143307.x
Subject(s) - medicine , referral , cephalosporin , antibiotics , penicillin , protocol (science) , pneumonia , emergency medicine , retrospective cohort study , tertiary referral hospital , pediatrics , family medicine , alternative medicine , pathology , microbiology and biotechnology , biology
Objective To assess the efficacy of an antibiotic protocol to avoid empirical use of third‐generation cephalosporins in community‐acquired pneumonia (CAP). Design and setting Retrospective case review of patients with CAP one year after implementing the protocol. Comparison was made with patients with CAP treated at a metropolitan tertiary referral hospital (where use of third‐generation cephalosporins was common). Participants 86 patients (district hospital with an antibiotic protocol) and 72 patients (metropolitan tertiary referral hospital). January – June 1999. Outcome measures Rate of staff adherence to the protocol; patient characteristics associated with poor protocol adherence; demographic and prognostic features of both groups at presentation; duration of intravenous therapy, time to defervescence, length of stay; inpatient mortality rates; and drug cost savings per patient treated according to the protocol. Results Overall protocol adherence rate was 60%. Patients with penicillin allergy were significantly less likely to receive treatment according to the protocol ( P <0.001). At the district hospital, patients were generally older and taking more regular medications, Patients at each hospital had similar prognostic factors and demographic features at presentation. Inhospital mortality ( P =0.92; 95% CI, ‐0.08 to 0.07), duration of fever ( P =0.57) and length of stay ( P =0.78) were not significantly different between patients treated empirically with penicillin and those treated empirically with third‐generation cephalosporins. Treating a patient according to the protocol saved an average of $77.44 in drug costs. Conclusion One year after implementation, our protocol for treating CAP is proving efficacious, although levels of adherence could improve.