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IMPLEMENTATION OF AN EMPIRICAL TREATMENT PROTOCOL FOR COMMUNITY-ACQUIRED PNEUMONIA IN A SOCIAL-HEALTHCARE HOSPITAL
Abstract:

INTRODUCTION

Community-acquired pneumonia (CAP) is a common acute infection associated with significant morbidity and mortality, particularly in older adults with significant comorbidities. For this reason, an empirical treatment protocol for CAP was developed in a social-health care hospital. The aim of the study is to evaluate compliance with this protocol.

METHODS

Descriptive, retrospective study of all patients admitted to our hospital diagnosed with CAP from September to December 2022.

Demographic variables: age, sex; pharmacological variables: empirical antibiotic treatment according to protocol, change of antibiotic treatment, mean duration of treatment, compliance with criteria and performance of sequential therapy on the third day and after the third day.

RESULTS AND DISUSSION

55 patients were included (mean age 88.9 years (64-103), 58.2% men).

50.9% received empirical antibiotic treatment according to the protocol. The empirical antibiotics prescribed were: amoxicillin/clavulanate (25.5%), ceftriaxone + levofloxacin (23.6%), piperacillin/tazobactam (18.2%), ceftriaxone (14.5%), levofloxacin (7.3%), meropenem (5.5%), ertapenem (1.8%), imipenem (1.8%) and levofloxacin + azithromyzine (1.8%).

Change of antibiotic in 27.3% and mean duration of treatment of 8.3 days.

Sequential therapy: 56.4% met criteria on day 3, but this was only done in 19.3%. Of the remaining patients, 22.45% were switched to oral, in an average of 6 days.

CONCLUSIONS

Compliance with the empirical treatment protocol in CAP occurred in a very low percentage of patients. Moreover, in patients who met the criteria for sequential therapy, it was performed after the third day. Therefore, with the aim of improving these results, new measures and activities have been proposed.

Keywords: CAP, empirical treatment, sequential therapy
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