Time to Guideline-Based Empiric Antibiotic Therapy in the Treatment of Pneumonia in a Community Hospital: A Retrospective Review
Purpose: The 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines for hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and health care-associated pneumonia (HCAP) stress the importance of initiating prompt appropriate empiric antibiotic...
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| Veröffentlicht in: | Journal of pharmacy practice 2016-08, Vol.29 (4), p.386-391 |
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| container_title | Journal of pharmacy practice |
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| creator | Erwin, Beth L. Kyle, Jeffrey A. Allen, Leland N. |
| description | Purpose:
The 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines for hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and health care-associated pneumonia (HCAP) stress the importance of initiating prompt appropriate empiric antibiotic therapy. This study’s purpose was to determine the percentage of patients with HAP, VAP, and HCAP who received guideline-based empiric antibiotic therapy and to determine the average time to receipt of an appropriate empiric regimen.
Methods:
A retrospective chart review of adults with HAP, VAP, or HCAP was conducted at a community hospital in suburban Birmingham, Alabama. The hospital’s electronic medical record system utilized International Classification of Diseases, Ninth Revision (ICD-9) codes to identify patients diagnosed with pneumonia. The percentage of patients who received guideline-based empiric antibiotic therapy was calculated. The mean time from suspected diagnosis of pneumonia to initial administration of the final antibiotic within the empiric regimen was calculated for patients who received guideline-based therapy.
Results:
Ninety-three patients met the inclusion criteria. The overall guideline adherence rate for empiric antibiotic therapy was 31.2%. The mean time to guideline-based therapy in hours:minutes was 7:47 for HAP and 28:16 for HCAP. For HAP and HCAP combined, the mean time to appropriate therapy was 21:55.
Conclusion:
Guideline adherence rates were lower and time to appropriate empiric therapy was greater for patients with HCAP compared to patients with HAP. |
| doi_str_mv | 10.1177/0897190014566303 |
| format | Article |
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The 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines for hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and health care-associated pneumonia (HCAP) stress the importance of initiating prompt appropriate empiric antibiotic therapy. This study’s purpose was to determine the percentage of patients with HAP, VAP, and HCAP who received guideline-based empiric antibiotic therapy and to determine the average time to receipt of an appropriate empiric regimen.
Methods:
A retrospective chart review of adults with HAP, VAP, or HCAP was conducted at a community hospital in suburban Birmingham, Alabama. The hospital’s electronic medical record system utilized International Classification of Diseases, Ninth Revision (ICD-9) codes to identify patients diagnosed with pneumonia. The percentage of patients who received guideline-based empiric antibiotic therapy was calculated. The mean time from suspected diagnosis of pneumonia to initial administration of the final antibiotic within the empiric regimen was calculated for patients who received guideline-based therapy.
Results:
Ninety-three patients met the inclusion criteria. The overall guideline adherence rate for empiric antibiotic therapy was 31.2%. The mean time to guideline-based therapy in hours:minutes was 7:47 for HAP and 28:16 for HCAP. For HAP and HCAP combined, the mean time to appropriate therapy was 21:55.
Conclusion:
Guideline adherence rates were lower and time to appropriate empiric therapy was greater for patients with HCAP compared to patients with HAP.</description><identifier>ISSN: 0897-1900</identifier><identifier>EISSN: 1531-1937</identifier><identifier>DOI: 10.1177/0897190014566303</identifier><identifier>PMID: 25601458</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Anti-Bacterial Agents - therapeutic use ; Electronic Health Records - standards ; Electronic Health Records - trends ; Empirical Research ; Female ; Guideline Adherence - standards ; Guideline Adherence - trends ; Hospitals, Community - methods ; Hospitals, Community - standards ; Hospitals, Community - trends ; Humans ; Iatrogenic Disease - epidemiology ; Male ; Middle Aged ; Pneumonia, Ventilator-Associated - diagnosis ; Pneumonia, Ventilator-Associated - drug therapy ; Pneumonia, Ventilator-Associated - epidemiology ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Journal of pharmacy practice, 2016-08, Vol.29 (4), p.386-391</ispartof><rights>The Author(s) 2015</rights><rights>The Author(s) 2015.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1353-78b1f808202d819ef16e72d9a9e8271d855fe6c2900521dc4b11d7f974e7d4953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0897190014566303$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0897190014566303$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25601458$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Erwin, Beth L.</creatorcontrib><creatorcontrib>Kyle, Jeffrey A.</creatorcontrib><creatorcontrib>Allen, Leland N.</creatorcontrib><title>Time to Guideline-Based Empiric Antibiotic Therapy in the Treatment of Pneumonia in a Community Hospital: A Retrospective Review</title><title>Journal of pharmacy practice</title><addtitle>J Pharm Pract</addtitle><description>Purpose:
The 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines for hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and health care-associated pneumonia (HCAP) stress the importance of initiating prompt appropriate empiric antibiotic therapy. This study’s purpose was to determine the percentage of patients with HAP, VAP, and HCAP who received guideline-based empiric antibiotic therapy and to determine the average time to receipt of an appropriate empiric regimen.
Methods:
A retrospective chart review of adults with HAP, VAP, or HCAP was conducted at a community hospital in suburban Birmingham, Alabama. The hospital’s electronic medical record system utilized International Classification of Diseases, Ninth Revision (ICD-9) codes to identify patients diagnosed with pneumonia. The percentage of patients who received guideline-based empiric antibiotic therapy was calculated. The mean time from suspected diagnosis of pneumonia to initial administration of the final antibiotic within the empiric regimen was calculated for patients who received guideline-based therapy.
Results:
Ninety-three patients met the inclusion criteria. The overall guideline adherence rate for empiric antibiotic therapy was 31.2%. The mean time to guideline-based therapy in hours:minutes was 7:47 for HAP and 28:16 for HCAP. For HAP and HCAP combined, the mean time to appropriate therapy was 21:55.
Conclusion:
Guideline adherence rates were lower and time to appropriate empiric therapy was greater for patients with HCAP compared to patients with HAP.</description><subject>Aged</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Electronic Health Records - standards</subject><subject>Electronic Health Records - trends</subject><subject>Empirical Research</subject><subject>Female</subject><subject>Guideline Adherence - standards</subject><subject>Guideline Adherence - trends</subject><subject>Hospitals, Community - methods</subject><subject>Hospitals, Community - standards</subject><subject>Hospitals, Community - trends</subject><subject>Humans</subject><subject>Iatrogenic Disease - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pneumonia, Ventilator-Associated - diagnosis</subject><subject>Pneumonia, Ventilator-Associated - drug therapy</subject><subject>Pneumonia, Ventilator-Associated - epidemiology</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0897-1900</issn><issn>1531-1937</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kL1v2zAUxImgQeMm3TsVHLso5aM-SI6u4ToFDDSDMwu0-BQzEEmVpAb_95HgtEOATu8B97sD7gj5AuweQIjvTCoBijGo6qYpWXlFVlCXUIAqxQeyWuRi0W_Ip5ReGONQlfwjueF1s3jkipwO1iHNge4ma3CwHosfOqGhWzfaaDu69tkebcjzezhh1OOZWk_zCekhos4Ofaahp48eJxe81Yuq6SY4N3mbz_QhpNFmPdyR614PCT-_3Vvy9HN72DwU-9-7X5v1vuigrMtCyCP0kknOuJGgsIcGBTdKK5RcgJF13WPT8blUzcF01RHAiF6JCoWpVF3ekm-X3DGGPxOm3DqbOhwG7TFMqQXJKs5AVWpG2QXtYkgpYt-O0Todzy2wdtm3fb_vbPn6lj4dHZp_hr-DzkBxAZJ-xvYlTNHPbf8f-ApKjIEr</recordid><startdate>201608</startdate><enddate>201608</enddate><creator>Erwin, Beth L.</creator><creator>Kyle, Jeffrey A.</creator><creator>Allen, Leland N.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201608</creationdate><title>Time to Guideline-Based Empiric Antibiotic Therapy in the Treatment of Pneumonia in a Community Hospital</title><author>Erwin, Beth L. ; Kyle, Jeffrey A. ; Allen, Leland N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1353-78b1f808202d819ef16e72d9a9e8271d855fe6c2900521dc4b11d7f974e7d4953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Electronic Health Records - standards</topic><topic>Electronic Health Records - trends</topic><topic>Empirical Research</topic><topic>Female</topic><topic>Guideline Adherence - standards</topic><topic>Guideline Adherence - trends</topic><topic>Hospitals, Community - methods</topic><topic>Hospitals, Community - standards</topic><topic>Hospitals, Community - trends</topic><topic>Humans</topic><topic>Iatrogenic Disease - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pneumonia, Ventilator-Associated - diagnosis</topic><topic>Pneumonia, Ventilator-Associated - drug therapy</topic><topic>Pneumonia, Ventilator-Associated - epidemiology</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Erwin, Beth L.</creatorcontrib><creatorcontrib>Kyle, Jeffrey A.</creatorcontrib><creatorcontrib>Allen, Leland N.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pharmacy practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Erwin, Beth L.</au><au>Kyle, Jeffrey A.</au><au>Allen, Leland N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time to Guideline-Based Empiric Antibiotic Therapy in the Treatment of Pneumonia in a Community Hospital: A Retrospective Review</atitle><jtitle>Journal of pharmacy practice</jtitle><addtitle>J Pharm Pract</addtitle><date>2016-08</date><risdate>2016</risdate><volume>29</volume><issue>4</issue><spage>386</spage><epage>391</epage><pages>386-391</pages><issn>0897-1900</issn><eissn>1531-1937</eissn><abstract>Purpose:
The 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines for hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and health care-associated pneumonia (HCAP) stress the importance of initiating prompt appropriate empiric antibiotic therapy. This study’s purpose was to determine the percentage of patients with HAP, VAP, and HCAP who received guideline-based empiric antibiotic therapy and to determine the average time to receipt of an appropriate empiric regimen.
Methods:
A retrospective chart review of adults with HAP, VAP, or HCAP was conducted at a community hospital in suburban Birmingham, Alabama. The hospital’s electronic medical record system utilized International Classification of Diseases, Ninth Revision (ICD-9) codes to identify patients diagnosed with pneumonia. The percentage of patients who received guideline-based empiric antibiotic therapy was calculated. The mean time from suspected diagnosis of pneumonia to initial administration of the final antibiotic within the empiric regimen was calculated for patients who received guideline-based therapy.
Results:
Ninety-three patients met the inclusion criteria. The overall guideline adherence rate for empiric antibiotic therapy was 31.2%. The mean time to guideline-based therapy in hours:minutes was 7:47 for HAP and 28:16 for HCAP. For HAP and HCAP combined, the mean time to appropriate therapy was 21:55.
Conclusion:
Guideline adherence rates were lower and time to appropriate empiric therapy was greater for patients with HCAP compared to patients with HAP.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>25601458</pmid><doi>10.1177/0897190014566303</doi><tpages>6</tpages></addata></record> |
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| ispartof | Journal of pharmacy practice, 2016-08, Vol.29 (4), p.386-391 |
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| source | Access via SAGE; MEDLINE |
| subjects | Aged Anti-Bacterial Agents - therapeutic use Electronic Health Records - standards Electronic Health Records - trends Empirical Research Female Guideline Adherence - standards Guideline Adherence - trends Hospitals, Community - methods Hospitals, Community - standards Hospitals, Community - trends Humans Iatrogenic Disease - epidemiology Male Middle Aged Pneumonia, Ventilator-Associated - diagnosis Pneumonia, Ventilator-Associated - drug therapy Pneumonia, Ventilator-Associated - epidemiology Retrospective Studies Treatment Outcome |
| title | Time to Guideline-Based Empiric Antibiotic Therapy in the Treatment of Pneumonia in a Community Hospital: A Retrospective Review |
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