Guideline Adherence Can Improve Pneumonia OutcomesLast Updated: September 17, 2009. Adult and elderly patients with community-acquired pneumonia achieve better outcomes when treated with empirical antimicrobial therapy in accordance with the 2007 professional guidelines, according to a pair of studies in the Sept. 14 issue of the Archives of Internal Medicine.
THURSDAY, Sept. 17 (HealthDay News) -- Adult and elderly patients with community-acquired pneumonia (CAP) achieve better outcomes when treated with empirical antimicrobial therapy in accordance with the 2007 professional guidelines for CAP, according to a pair of studies in the Sept. 14 issue of the Archives of Internal Medicine.
In one study, Forest W. Arnold, D.O., of the University of Louisville in Kentucky, and colleagues assessed the adherence to the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) guidelines for CAP patients 65 years and older treated at 43 hospitals. The patients who were treated in accordance with the guidelines had lower overall in-hospital mortality (8 versus 17 percent), decreased time to clinical stability (71 percent within seven days versus 57 percent), and a shorter median length of stay (8 versus 10 days).
In another study, Caitlin McCabe, of the Hospital for Sick Children in Toronto, and colleagues analyzed data on 54,619 adult CAP patients hospitalized at 113 hospitals. Therapy in compliance with IDSA/ATS guidelines decreased risk of sepsis (odds ratio, 0.83), renal failure (odds ratio, 0.79), and in-hospital mortality (odds ratio, 0.70) compared to non-compliant therapy. Compliant therapy also reduced mean hospital length of stay by 0.66 days.
"Although clinical practice guidelines should never obviate the need to consider carefully the peculiarities of a given clinical scenario, our findings provide an additional support for such guidelines as a high-quality, default path of care for adults sufficiently ill to require non-intensive care unit hospitalization," McCabe and colleagues conclude.
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