Chávez-Plascencia E, Tovar-Serrano A, Pérez-Padilla JR

Language: Spanish
References: 21
Page: 11-16
PDF size: 235.43 Kb.

ABSTRACT

Background: Community acquired pneumonia (CAP) is a common infection and one of the leading mortality causes worldwide Quality evaluation is important for making an opportune diagnosis and correct treatment. Our objective is to define the management of hospitalized community acquired pneumonia patients in a Mexico City private institution during one year of attention, to establish the number of patients receiving treatment according to current guidelines.
Material and methods: Retrospective study in a Mexico City private institution, from January 1st to December 31st, 2005. Inclusion criteria: all patients with community acquired pneumonia diagnosis, age ≥ 18 years, without missing data.
Results: For the final analysis there were 40 patients included. Mean Severity Pneumonia Index 87 ± 38 points, class III to V (77.5%). The etiology agent was identified in 12.8%. 12(42.8%) received antibiotics in the first 4 hours, and all the patients received it in the first 24 hours. 33(82.5%) presented pneumonia resolution and 4(10%) therapeutic failure.
Conclusion: The established guidelines for community acquired pneumonia are partially followed in our institution. 47.5% of the treatment did not cover atypical agents and 20% had doubtful cover on pneumococcus.

REFERENCES

1. Goldman. Cecil Textbook of Medicine. 22nd ed. New York: WB Saunders. Chapter 92.

2. Nawal M, Henley E, Chang L. Diagnosis and treatment of community acquired pneumonia. Am Fam Phys 2006;73:442- 450.

3. Guidelines for the Management of Adults with Community –acquired Pneumonia. Diagnosis, Assessment of Severity, Antimicrobial Therapy, and Prevention. Am J Resp Crit Care 2001;163(7).

4. Riley P, Aronsky D, Dean N. Validation of the 2001 American Thoracic Society criteria for severe community-acquired pneumonia. Crit Care Med 2004; 32:2398-2402.

5. Ramírez J. An International, Observational study to evaluate current management of hospitalized patients with community acquired pneumonia (International CAP study). International Community Acquired Pneumonia Organization.

6. Mandell L. Epidemiology and etiology of community-acquired pneumonia. Infect Dis Clin N Am 2004:761-776.

7. Estadísticas demográficas 2005. INEGI. www.inegi.gob.mx

8. Mortensen E, Restrepo M, Anzueto A, Pugh J. Antibiotic therapy and 48-hour mortality for patients with pneumonia. Am J Med 2006;119:859-864.

9. Fee C, Weber E. Identification of 90% of patients ultimately diagnosed with community-acquired pneumonia within four hours of emergency department arrival may not be feasible. Ann Emerg Med 2007;49:553-559.

10. Nolt B, Gonzales R, Masselli J, Aagaard E, Camargo C, Metlay J. Vital-sign abnormalities as predictors of pneumonia in adults with acute cough illness. Am J Emerg Med 2007;25:631- 636.

11. Balanzó X, Sauca G, Almirall J, Bolíbar I, et al. Contribution of C-Reactive protein to the diagnosis and assessment of severity of community-acquired pneumonia. Chest 2004;125:1335- 1342.

12. Sin D, Man P, Marrie T. Arterial carbon dioxide tension on admission as a marker of in-hospital mortality in communityacquired pneumonia. Am J Med 2005; 118:145-150.

13. Falguera M, Martín M, Ruíz-González A, Pifarré R, García M. Communiy acquired pneumonia as the initial manifestation of serious underlying diseases. Am J Med 2005;118:378-383.

14. Halm E, Teirstein A. Management of community-acquired pneumonia. N Eng J Med. 2002;347(25):2039-2045.

15. Marras T, Nopmaneejumruslers C, Chan N. Efficacy of exclusively oral antibiotic therapy in patients hospitalized with nonsevere community-acquired pneumonia: a retrospective study and meta-analysis. Am J Med. 2004;116:385- 393.

16. Frei C, Restrepo M, Mortensen E, Burgess D. Impact of guideline-concordant empiric antibiotic therapy in communityacquired pneumonia. Am J Med 2006;119:865-871.

17. Marrie T. Huang J. Low-risk patients admitted with communityacquired pneumonia. Am J Med 2005;118:1357-1363.

18. Aujesky D, Auble T, Yealy D, Stone R, et al. Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. Am J Med 2005;118:384- 392.

19. Basi S, Marrie T, Huang J, Majumdar S. Patients admitted to hospital with Suspected Pneumonia and Normal Chest Radiographs: Epidemiology, Microbiology, and Outcomes. Am J Med 2004;117:305-311.

20. Neuman M, Willett W, Curhan Gary. Vitamin and micronutrient intake and the risk of community acquired pneumonia in US women. Am J Med 2007;120:330-336.

21. Colice G, Morley M, Bimbaum H. Treatment costs of community- acquired pneumonia in an employed population. Chest 2004;125:2140-2145.