Antibiotic therapy of community-acquired pneumonia in the hospital setting: national guidelines and real clinical practice
Abstract
<b>Aim:</b> Analysis of the practice of systemic antibacterial drugs (ABD) in patients with community-acquired pneumonia (CAP). <b>Materials and methods:</b> In a retrospective cohort study investigated 100 medical cards of patients and lists of medical appointments who hospitalized in the pulmonology department with a diagnosis community-acquired pneumonia in the period July 2014 - May 2015. <b>Results:</b> Start antibiotic therapy in the hospital determined by the appointment: 20% of ceftriaxone, 15% of levofloxacin, 12% azithromycin, 7% tsefperazona, 7% of ciprofloxacin, 4% amoksiksitsillin / clavulanate, 3% moxifloxacin, 15% of ceftriaxone + levofloxacin, 12% of ceftriaxone + azithromycin 5% ciprofloxacin, ceftriaxone + 5%. Percentage of Compliance of start ABT with national guidelines for CAP treatment in hospital setting was 48%. The structure of the start ABT in monotherapy was 40%, in combined therapy - 60%. The method of administration ABD in structure start ABT determined with drug administration: per os in 2% cases, i / m - 35% i / v - 40%, per os + i / m - 5% and per os + i /v - 12% and i/ m + i /v - 6% . The correction of starting ABT in patients with CAP took in 49% of patients, including once in 62.1% of patients, doubly - 28.6% and in 10.2% three times. Etiological justified change of the ABT noted only in 10% cases. The concept of a stepped introduction of the ABD was only in 2.7%. <b>Conclusion:</b> The low rate of compliance with national guiedlines for CAP treatment in a hospital setting, a high failure rate of start ABT and low adherence to the concept of sequential therapy.