Antimicrobial prescribing and outcomes of community-acquired pneumonia in Australian hospitalized patients: a cross-sectional study.

{"article_title":"Antimicrobial prescribing and outcomes of community-acquired pneumonia in Australian hospitalized patients: a cross-sectional study.","author":"Robert L, Mark V, Moayed A, Nivashen A, Vinod R, Sophie P, Mohamed EW, Rusheng C","journal_title":"The Journal of international medical research","issn":"1473-2300","isbn":"","publication_date":"2021 Nov","volume":"49","issue":"11","first_page":"3000610000000000","page_count":"","accession_number":"34826375","doi":"10.1177\/03000605211058366","publisher":"Sage Publications","doctype":"Journal Article","subjects":"Australia; Anti-Infective Agents therapeutic use; Community-Acquired Infections drug therapy; Pneumonia drug therapy; Adult; Anti-Bacterial Agents therapeutic use; Australia; Cross-Sectional Studies; Humans; Retrospective Studies","interest_area":["Pulmonology"," Emergency Medicine"," Infectious Disease & Vaccines"],"abstract":"Objective: We aimed to assess prescribing practices, compliance with guidelines, and outcomes for patients who were admitted to the authors' institution with community-acquired pneumonia (CAP). Methods: We performed a single-center retrospective cross-sectional study of adults with CAP presenting during the 2019 influenza season. CAP severity was assessed using the CURB-65 risk score. The effect of CURB-65 risk score use on the rate of appropriate antimicrobial prescribing was assessed using the chi-square test and reported as odds ratio (OR). Fisher's exact test was used to assess the relationship between prescribing appropriateness and patient outcomes. Results: Patients with low-risk CAP were most likely to be inappropriately prescribed antimicrobials (OR: 4.77; 95% confidence interval: 2.44-10.47). In low-risk CAP, the most common prescribing error was overuse of ceftriaxone. In high-risk CAP, the most common errors were ceftriaxone underdosing and missed atypical coverage with azithromycin. Overall, 80% of patients were considered to have been inappropriately prescribed antimicrobials. No effect on mortality was observed. Conclusions: In this study, we found low use of CAP risk scores and low adherence to antimicrobial prescribing guidelines for CAP at the authors' institution.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=34826375&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Robert L, Mark V, Moayed A, Nivashen A, Vinod R, Sophie P, Mohamed EW, Rusheng C","Journal_Info":"Publisher: Sage Publications Country of Publication: England NLM ID: 0346411 Publication Model: Print Cited Medium: Internet ISSN: 1473-2300 (Electronic) Linking ISSN: 03000605 NLM ISO Abbreviation: J Int Med Res Subsets: MEDLINE","Publication_Type":"Journal Article","Published_Date":"2021-11-01","Source":"The Journal of international medical research [J Int Med Res] 2021 Nov; Vol. 49 (11), pp. 3000605211058366.","Languages":"English","Electronic_ISSN":"1473-2300","MeSH_Terms":"Anti-Infective Agents*\/therapeutic use , Community-Acquired Infections*\/drug therapy , Pneumonia*\/drug therapy, Adult ; Anti-Bacterial Agents\/therapeutic use ; Australia ; Cross-Sectional Studies ; Humans ; Retrospective Studies","Subjects":"Adult, Anti-Bacterial Agents therapeutic use, Australia, Cross-Sectional Studies, Humans, Retrospective Studies, Anti-Infective Agents therapeutic use, Community-Acquired Infections drug therapy, Pneumonia drug therapy","Title_Abbreviations":"The Journal of international medical research","Volume":"49"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"34826375","RelevancyScore":"870","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"869.862670898438"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=34826375&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=34826375&authtype=shib&custid=ns346513&group=main&profile=eds"}