Management of Community Acquired Pneumonia Patients and Evaluation of Adherence to the Guidelines

• Main Authors: Zeliha KOÇAK TUFAN, Gülbin P. CANPOLAT, Cemal BULUT, Çiğdem ATAMAN HATİPOĞLU, Sami KINIKLI, Ali Pekcan DEMİRÖZ
• Format: Article
• Language: English
• Published: Bilimsel Tip Yayinevi 2011-12-01
• Series: Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi
• Subjects: Pneumonia; Disease management; Guideline adherence
• Online Access: http://www.floradergisi.org/getFileContent.aspx?op=REDPDF&file_name=2011-16-04-146-151.pdf

Introduction: The aim of this study was to investigate the risk factors and clinical findings of hospitalized patients with community-acquired pneumonia and evaluate adherence to the guidelines in the routine follow-up. Materials and Methods: Those patients hospitalized between June 2010 and June 2011 with the diagnosis of community-acquired pneumonia were included. Patient files were investigated. CURB-65 and Pneumonia Severity Index (PSI) scores were calculated. Results: Totally, 70 patients were included. The highest risk factor was smoking (36%), the most frequent symptom was fever (83%) and the most frequent physical finding was fine crackles (59%). Regarding the pulmonary involvement, 76% was unilateral and 94% showed consolidation. CURB-65 scores were as follows: 41 (58.6%) patients < 2 and 29 (41.4%) patients ≥ 2. PSI scores by group were as follows: 7 (10%) patients in group V, 35 (50%) in group IV, 10 (14.3%) in group III, 15 (21.4%) in group II, and 1 (4.3%) in group I. Mean hospitalization duration was six days (1-15 days). Most of the blood cultures (95%) were negative. Legionella antigen, Mycoplasma IgM and Chlamydophila IgM were positive in 3%, 7% and 9%, respectively. The most frequently used antibiotic in the empirical therapy was ceftriaxone-clarithromycin combination therapy (37%), followed by moxifloxacin (26%) and levofloxacin (17%). Conclusion: CURB-65 and PSI scores are not included routinely in the clinical decision for hospitalization criteria. The benefit of the serological tests in the empirical therapy decision is limited. Although the isolation rate of the etiologic agents is low, the empirical treatment and the duration of treatment of pneumonia patients in our clinic generally seem to be adherent to the guidelines.