Guideline-Based Antibiotics and Mortality in Healthcare-Associated Pneumonia
ABSTRACT Background Guidelines recommend administration of antibiotics with activity against methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa for treatment of healthcare-associated pneumonia (HCAP). It is unclear if this therapy improves outcomes for patients with HCAP....
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| Veröffentlicht in: | Journal of general internal medicine : JGIM 2012-07, Vol.27 (7), p.845-852 |
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| creator | Madaras-Kelly, Karl J. Remington, Richard E. Sloan, Kevin L. Fan, Vincent S. |
| description | ABSTRACT
Background
Guidelines recommend administration of antibiotics with activity against methicillin-resistant
Staphylococcus aureus
(MRSA) and
Pseudomonas aeruginosa
for treatment of healthcare-associated pneumonia (HCAP). It is unclear if this therapy improves outcomes for patients with HCAP.
Objective
To determine if administration of guideline-similar therapy (GST) was associated with a reduction in 30-day mortality for HCAP.
Design
Multi-center retrospective study.
Participants
Thirteen hundred and eleven admissions for HCAP in six Veterans Affairs Medical Centers.
Interventions
Each admission was classified as receiving GST, anti-MRSA or anti-pseudomonal components of GST, or other non-HCAP therapy initiated within 48 hours of hospitalization. Association between 30-day mortality and GST was estimated with a logistic regression model that included GST, propensity to receive GST, probability of recovering an organism from culture resistant to antibiotics traditionally used to treat community-acquired pneumonia (CAP-resistance), and a GST by CAP-resistance probability interaction.
Main Measures
Odds ratios and 95% confidence intervals [OR (95% CI)] of 30-day mortality for patients treated with GST and predicted probability of recovering a CAP-resistant organism, and ratio of odds ratios [ROR (95% CI)] for treatment by CAP-resistance probability interaction.
Key Results
Receipt of GST was associated with increased odds of 30-day mortality [OR = 2.11 (1.11, 4.04),
P
= 0.02)] as was the predicted probability of recovering a CAP-resistant organism [OR = 1.67 (1.26, 2.20),
P
|
| doi_str_mv | 10.1007/s11606-012-2011-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3378737</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1021451567</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-a924a5a9a69cb268235f91a848302a912fcd6bdbf49b94d752c8277cf93aaf8d3</originalsourceid><addsrcrecordid>eNqFkUFv1DAQhS0EokvhB3BBkbhwMfXYSWxfkJYKWqRF7QHO1sRxWldZu9gO0v57vGypClLFXHyY770ZzyPkNbD3wJg8yQA96ykDTjkDoLsnZAUd7yi0Wj4lK6ZUS5UU7RF5kfMNYyA4V8_JEedC9wBsRTZnix_d7IOjHzG7sVmH4gcfi7e5wTA2X2MqOPuya3xozh3O5dpicnSdc7QeS5VcBrdsY_D4kjybcM7u1d17TL5__vTt9JxuLs6-nK431HZMFIqat9ihxl7bgfeKi27SgKpVgnHUwCc79sM4TK0edDvKjlvFpbSTFoiTGsUx-XDwvV2GrRutCyXhbG6T32LamYje_N0J_tpcxZ9GCFnPIavBuzuDFH8sLhez9dm6ecbg4pINyL4uJTUT_0cZh7aDrt-7vv0HvYlLCvUSv6laSrJKwYGyKeac3HS_NzCzj9UcYjU1VrOP1eyq5s3DD98r_uRYAX4Acm2FK5cejn7M9Rfvx63L</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1021111870</pqid></control><display><type>article</type><title>Guideline-Based Antibiotics and Mortality in Healthcare-Associated Pneumonia</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Madaras-Kelly, Karl J. ; Remington, Richard E. ; Sloan, Kevin L. ; Fan, Vincent S.</creator><creatorcontrib>Madaras-Kelly, Karl J. ; Remington, Richard E. ; Sloan, Kevin L. ; Fan, Vincent S.</creatorcontrib><description>ABSTRACT
Background
Guidelines recommend administration of antibiotics with activity against methicillin-resistant
Staphylococcus aureus
(MRSA) and
Pseudomonas aeruginosa
for treatment of healthcare-associated pneumonia (HCAP). It is unclear if this therapy improves outcomes for patients with HCAP.
Objective
To determine if administration of guideline-similar therapy (GST) was associated with a reduction in 30-day mortality for HCAP.
Design
Multi-center retrospective study.
Participants
Thirteen hundred and eleven admissions for HCAP in six Veterans Affairs Medical Centers.
Interventions
Each admission was classified as receiving GST, anti-MRSA or anti-pseudomonal components of GST, or other non-HCAP therapy initiated within 48 hours of hospitalization. Association between 30-day mortality and GST was estimated with a logistic regression model that included GST, propensity to receive GST, probability of recovering an organism from culture resistant to antibiotics traditionally used to treat community-acquired pneumonia (CAP-resistance), and a GST by CAP-resistance probability interaction.
Main Measures
Odds ratios and 95% confidence intervals [OR (95% CI)] of 30-day mortality for patients treated with GST and predicted probability of recovering a CAP-resistant organism, and ratio of odds ratios [ROR (95% CI)] for treatment by CAP-resistance probability interaction.
Key Results
Receipt of GST was associated with increased odds of 30-day mortality [OR = 2.11 (1.11, 4.04),
P
= 0.02)] as was the predicted probability of recovering a CAP-resistant organism [OR = 1.67 (1.26, 2.20),
P
< 0.001 for a 25% increase in probability]. An interaction between predicted probability of recovering a CAP-resistant organism and receipt of GST demonstrated lower mortality with GST at high probability of CAP resistance [ROR = 0.71(≤1.00) for a 25% increase in probability,
P
= 0.05].
Conclusions
For HCAP patients with high probability of CAP-resistant organisms, GST was associated with lower mortality. Consideration of the magnitude of patient-specific risk for CAP-resistant organisms should be considered when selecting HCAP therapy.</description><identifier>ISSN: 0884-8734</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1007/s11606-012-2011-y</identifier><identifier>PMID: 22396110</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Aged ; Aged, 80 and over ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Cross Infection - drug therapy ; Cross Infection - mortality ; Drug resistance ; Drug therapy ; Drug Therapy, Combination ; Female ; Guideline Adherence - statistics & numerical data ; Humans ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Mortality ; Nosocomial infections ; Original Research ; Pneumonia ; Pneumonia, Bacterial - drug therapy ; Pneumonia, Bacterial - mortality ; Pneumonia, Staphylococcal - drug therapy ; Pneumonia, Staphylococcal - mortality ; Practice Guidelines as Topic ; Practice Patterns, Physicians' - statistics & numerical data ; Pseudomonas aeruginosa ; Pseudomonas Infections - drug therapy ; Pseudomonas Infections - mortality ; Retrospective Studies ; Staphylococcus aureus ; United States - epidemiology</subject><ispartof>Journal of general internal medicine : JGIM, 2012-07, Vol.27 (7), p.845-852</ispartof><rights>Society of General Internal Medicine 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-a924a5a9a69cb268235f91a848302a912fcd6bdbf49b94d752c8277cf93aaf8d3</citedby><cites>FETCH-LOGICAL-c503t-a924a5a9a69cb268235f91a848302a912fcd6bdbf49b94d752c8277cf93aaf8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378737/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378737/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,41488,42557,51319,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22396110$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Madaras-Kelly, Karl J.</creatorcontrib><creatorcontrib>Remington, Richard E.</creatorcontrib><creatorcontrib>Sloan, Kevin L.</creatorcontrib><creatorcontrib>Fan, Vincent S.</creatorcontrib><title>Guideline-Based Antibiotics and Mortality in Healthcare-Associated Pneumonia</title><title>Journal of general internal medicine : JGIM</title><addtitle>J GEN INTERN MED</addtitle><addtitle>J Gen Intern Med</addtitle><description>ABSTRACT
Background
Guidelines recommend administration of antibiotics with activity against methicillin-resistant
Staphylococcus aureus
(MRSA) and
Pseudomonas aeruginosa
for treatment of healthcare-associated pneumonia (HCAP). It is unclear if this therapy improves outcomes for patients with HCAP.
Objective
To determine if administration of guideline-similar therapy (GST) was associated with a reduction in 30-day mortality for HCAP.
Design
Multi-center retrospective study.
Participants
Thirteen hundred and eleven admissions for HCAP in six Veterans Affairs Medical Centers.
Interventions
Each admission was classified as receiving GST, anti-MRSA or anti-pseudomonal components of GST, or other non-HCAP therapy initiated within 48 hours of hospitalization. Association between 30-day mortality and GST was estimated with a logistic regression model that included GST, propensity to receive GST, probability of recovering an organism from culture resistant to antibiotics traditionally used to treat community-acquired pneumonia (CAP-resistance), and a GST by CAP-resistance probability interaction.
Main Measures
Odds ratios and 95% confidence intervals [OR (95% CI)] of 30-day mortality for patients treated with GST and predicted probability of recovering a CAP-resistant organism, and ratio of odds ratios [ROR (95% CI)] for treatment by CAP-resistance probability interaction.
Key Results
Receipt of GST was associated with increased odds of 30-day mortality [OR = 2.11 (1.11, 4.04),
P
= 0.02)] as was the predicted probability of recovering a CAP-resistant organism [OR = 1.67 (1.26, 2.20),
P
< 0.001 for a 25% increase in probability]. An interaction between predicted probability of recovering a CAP-resistant organism and receipt of GST demonstrated lower mortality with GST at high probability of CAP resistance [ROR = 0.71(≤1.00) for a 25% increase in probability,
P
= 0.05].
Conclusions
For HCAP patients with high probability of CAP-resistant organisms, GST was associated with lower mortality. Consideration of the magnitude of patient-specific risk for CAP-resistant organisms should be considered when selecting HCAP therapy.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Cross Infection - drug therapy</subject><subject>Cross Infection - mortality</subject><subject>Drug resistance</subject><subject>Drug therapy</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Guideline Adherence - statistics & numerical data</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methicillin-Resistant Staphylococcus aureus</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nosocomial infections</subject><subject>Original Research</subject><subject>Pneumonia</subject><subject>Pneumonia, Bacterial - drug therapy</subject><subject>Pneumonia, Bacterial - mortality</subject><subject>Pneumonia, Staphylococcal - drug therapy</subject><subject>Pneumonia, Staphylococcal - mortality</subject><subject>Practice Guidelines as Topic</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Pseudomonas aeruginosa</subject><subject>Pseudomonas Infections - drug therapy</subject><subject>Pseudomonas Infections - mortality</subject><subject>Retrospective Studies</subject><subject>Staphylococcus aureus</subject><subject>United States - epidemiology</subject><issn>0884-8734</issn><issn>1525-1497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkUFv1DAQhS0EokvhB3BBkbhwMfXYSWxfkJYKWqRF7QHO1sRxWldZu9gO0v57vGypClLFXHyY770ZzyPkNbD3wJg8yQA96ykDTjkDoLsnZAUd7yi0Wj4lK6ZUS5UU7RF5kfMNYyA4V8_JEedC9wBsRTZnix_d7IOjHzG7sVmH4gcfi7e5wTA2X2MqOPuya3xozh3O5dpicnSdc7QeS5VcBrdsY_D4kjybcM7u1d17TL5__vTt9JxuLs6-nK431HZMFIqat9ihxl7bgfeKi27SgKpVgnHUwCc79sM4TK0edDvKjlvFpbSTFoiTGsUx-XDwvV2GrRutCyXhbG6T32LamYje_N0J_tpcxZ9GCFnPIavBuzuDFH8sLhez9dm6ecbg4pINyL4uJTUT_0cZh7aDrt-7vv0HvYlLCvUSv6laSrJKwYGyKeac3HS_NzCzj9UcYjU1VrOP1eyq5s3DD98r_uRYAX4Acm2FK5cejn7M9Rfvx63L</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Madaras-Kelly, Karl J.</creator><creator>Remington, Richard E.</creator><creator>Sloan, Kevin L.</creator><creator>Fan, Vincent S.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</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>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20120701</creationdate><title>Guideline-Based Antibiotics and Mortality in Healthcare-Associated Pneumonia</title><author>Madaras-Kelly, Karl J. ; Remington, Richard E. ; Sloan, Kevin L. ; Fan, Vincent S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-a924a5a9a69cb268235f91a848302a912fcd6bdbf49b94d752c8277cf93aaf8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Cross Infection - drug therapy</topic><topic>Cross Infection - mortality</topic><topic>Drug resistance</topic><topic>Drug therapy</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Guideline Adherence - statistics & numerical data</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methicillin-Resistant Staphylococcus aureus</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nosocomial infections</topic><topic>Original Research</topic><topic>Pneumonia</topic><topic>Pneumonia, Bacterial - drug therapy</topic><topic>Pneumonia, Bacterial - mortality</topic><topic>Pneumonia, Staphylococcal - drug therapy</topic><topic>Pneumonia, Staphylococcal - mortality</topic><topic>Practice Guidelines as Topic</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Pseudomonas aeruginosa</topic><topic>Pseudomonas Infections - drug therapy</topic><topic>Pseudomonas Infections - mortality</topic><topic>Retrospective Studies</topic><topic>Staphylococcus aureus</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Madaras-Kelly, Karl J.</creatorcontrib><creatorcontrib>Remington, Richard E.</creatorcontrib><creatorcontrib>Sloan, Kevin L.</creatorcontrib><creatorcontrib>Fan, Vincent S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of general internal medicine : JGIM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Madaras-Kelly, Karl J.</au><au>Remington, Richard E.</au><au>Sloan, Kevin L.</au><au>Fan, Vincent S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Guideline-Based Antibiotics and Mortality in Healthcare-Associated Pneumonia</atitle><jtitle>Journal of general internal medicine : JGIM</jtitle><stitle>J GEN INTERN MED</stitle><addtitle>J Gen Intern Med</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>27</volume><issue>7</issue><spage>845</spage><epage>852</epage><pages>845-852</pages><issn>0884-8734</issn><eissn>1525-1497</eissn><abstract>ABSTRACT
Background
Guidelines recommend administration of antibiotics with activity against methicillin-resistant
Staphylococcus aureus
(MRSA) and
Pseudomonas aeruginosa
for treatment of healthcare-associated pneumonia (HCAP). It is unclear if this therapy improves outcomes for patients with HCAP.
Objective
To determine if administration of guideline-similar therapy (GST) was associated with a reduction in 30-day mortality for HCAP.
Design
Multi-center retrospective study.
Participants
Thirteen hundred and eleven admissions for HCAP in six Veterans Affairs Medical Centers.
Interventions
Each admission was classified as receiving GST, anti-MRSA or anti-pseudomonal components of GST, or other non-HCAP therapy initiated within 48 hours of hospitalization. Association between 30-day mortality and GST was estimated with a logistic regression model that included GST, propensity to receive GST, probability of recovering an organism from culture resistant to antibiotics traditionally used to treat community-acquired pneumonia (CAP-resistance), and a GST by CAP-resistance probability interaction.
Main Measures
Odds ratios and 95% confidence intervals [OR (95% CI)] of 30-day mortality for patients treated with GST and predicted probability of recovering a CAP-resistant organism, and ratio of odds ratios [ROR (95% CI)] for treatment by CAP-resistance probability interaction.
Key Results
Receipt of GST was associated with increased odds of 30-day mortality [OR = 2.11 (1.11, 4.04),
P
= 0.02)] as was the predicted probability of recovering a CAP-resistant organism [OR = 1.67 (1.26, 2.20),
P
< 0.001 for a 25% increase in probability]. An interaction between predicted probability of recovering a CAP-resistant organism and receipt of GST demonstrated lower mortality with GST at high probability of CAP resistance [ROR = 0.71(≤1.00) for a 25% increase in probability,
P
= 0.05].
Conclusions
For HCAP patients with high probability of CAP-resistant organisms, GST was associated with lower mortality. Consideration of the magnitude of patient-specific risk for CAP-resistant organisms should be considered when selecting HCAP therapy.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22396110</pmid><doi>10.1007/s11606-012-2011-y</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0884-8734 |
| ispartof | Journal of general internal medicine : JGIM, 2012-07, Vol.27 (7), p.845-852 |
| issn | 0884-8734 1525-1497 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3378737 |
| source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged Aged, 80 and over Anti-Bacterial Agents - therapeutic use Antibiotics Cross Infection - drug therapy Cross Infection - mortality Drug resistance Drug therapy Drug Therapy, Combination Female Guideline Adherence - statistics & numerical data Humans Internal Medicine Male Medicine Medicine & Public Health Methicillin-Resistant Staphylococcus aureus Middle Aged Mortality Nosocomial infections Original Research Pneumonia Pneumonia, Bacterial - drug therapy Pneumonia, Bacterial - mortality Pneumonia, Staphylococcal - drug therapy Pneumonia, Staphylococcal - mortality Practice Guidelines as Topic Practice Patterns, Physicians' - statistics & numerical data Pseudomonas aeruginosa Pseudomonas Infections - drug therapy Pseudomonas Infections - mortality Retrospective Studies Staphylococcus aureus United States - epidemiology |
| title | Guideline-Based Antibiotics and Mortality in Healthcare-Associated Pneumonia |
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