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The efficacy of an antibiotic protocol for community‐acquired pneumonia
ABSTRACT Objective To assess the efficacy of an antibiotic protocol to avoid empirical use of third‐generation cephalosporins in community‐acquired pneumonia (CAP). Design and setting Retrospective case review of patients with CAP one year after implementing the protocol. Comparison was made with pa...
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| Published in: | Medical journal of Australia 2001-04, Vol.174 (7), p.333-337 |
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| Language: | English |
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| container_end_page | 337 |
| container_issue | 7 |
| container_start_page | 333 |
| container_title | Medical journal of Australia |
| container_volume | 174 |
| creator | Dobbin, Catherine J Duggan, Christopher J Barnes, David J |
| description | ABSTRACT
Objective
To assess the efficacy of an antibiotic protocol to avoid empirical use of third‐generation cephalosporins in community‐acquired pneumonia (CAP).
Design and setting
Retrospective case review of patients with CAP one year after implementing the protocol. Comparison was made with patients with CAP treated at a metropolitan tertiary referral hospital (where use of third‐generation cephalosporins was common).
Participants
86 patients (district hospital with an antibiotic protocol) and 72 patients (metropolitan tertiary referral hospital). January – June 1999.
Outcome measures
Rate of staff adherence to the protocol; patient characteristics associated with poor protocol adherence; demographic and prognostic features of both groups at presentation; duration of intravenous therapy, time to defervescence, length of stay; inpatient mortality rates; and drug cost savings per patient treated according to the protocol.
Results
Overall protocol adherence rate was 60%. Patients with penicillin allergy were significantly less likely to receive treatment according to the protocol (P |
| doi_str_mv | 10.5694/j.1326-5377.2001.tb143307.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70836378</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70836378</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4327-695b569a67e9d0b73457da939ae90eef6ecaa7b58d2ee0b508cde9c81a53fcdc3</originalsourceid><addsrcrecordid>eNqVkMtKxDAUhoMoOl5eQQqCu9ZcmqbB1Th4RXEzgruQpieYoW1mmhZndj6Cz-iT2GFGXQuBcDjfyfnzIXRGcMIzmV7MEsJoFnMmREIxJklXkJQxLJLlDhr99nbRCGPKY0Hl6wE6DGE2lIRTsY8OCGFpRjAfofvpG0RgrTParCJvI90Mp3OF850z0bz1nTe-iqxvI-Prum9ct_r6-NRm0bsWymjeQF_7xuljtGd1FeBkex-hl5vr6eQufny-vZ-MH2OTMiriTPJi-IbOBMgSF4KlXJRaMqlBYgCbgdFaFDwvKQAuOM5NCdLkRHNmTWnYETrfvDtkW_QQOlW7YKCqdAO-D0rgnGVM5AN4uQFN60Nowap562rdrhTBam1SzdTallrbUmuT6sekWg7Tp9s1fVFD-Te7VTcAZ1tAB6Mr2-rGuPDLyVxmgg7U9YZ6dxWs_pNAPT2M6fRqU7JvXuOUJA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70836378</pqid></control><display><type>article</type><title>The efficacy of an antibiotic protocol for community‐acquired pneumonia</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Dobbin, Catherine J ; Duggan, Christopher J ; Barnes, David J</creator><creatorcontrib>Dobbin, Catherine J ; Duggan, Christopher J ; Barnes, David J</creatorcontrib><description>ABSTRACT
Objective
To assess the efficacy of an antibiotic protocol to avoid empirical use of third‐generation cephalosporins in community‐acquired pneumonia (CAP).
Design and setting
Retrospective case review of patients with CAP one year after implementing the protocol. Comparison was made with patients with CAP treated at a metropolitan tertiary referral hospital (where use of third‐generation cephalosporins was common).
Participants
86 patients (district hospital with an antibiotic protocol) and 72 patients (metropolitan tertiary referral hospital). January – June 1999.
Outcome measures
Rate of staff adherence to the protocol; patient characteristics associated with poor protocol adherence; demographic and prognostic features of both groups at presentation; duration of intravenous therapy, time to defervescence, length of stay; inpatient mortality rates; and drug cost savings per patient treated according to the protocol.
Results
Overall protocol adherence rate was 60%. Patients with penicillin allergy were significantly less likely to receive treatment according to the protocol (P<0.001). At the district hospital, patients were generally older and taking more regular medications, Patients at each hospital had similar prognostic factors and demographic features at presentation. Inhospital mortality (P=0.92; 95% CI, ‐0.08 to 0.07), duration of fever (P=0.57) and length of stay (P=0.78) were not significantly different between patients treated empirically with penicillin and those treated empirically with third‐generation cephalosporins. Treating a patient according to the protocol saved an average of $77.44 in drug costs.
Conclusion
One year after implementation, our protocol for treating CAP is proving efficacious, although levels of adherence could improve.</description><identifier>ISSN: 0025-729X</identifier><identifier>EISSN: 1326-5377</identifier><identifier>DOI: 10.5694/j.1326-5377.2001.tb143307.x</identifier><identifier>PMID: 11346105</identifier><identifier>CODEN: MJAUAJ</identifier><language>eng</language><publisher>Sydney: Australasian Medical Publishing Company</publisher><subject>Adult ; Aged ; Ampicillin - economics ; Ampicillin - therapeutic use ; Anti-Bacterial Agents - economics ; Anti-Bacterial Agents - therapeutic use ; Antibacterial agents ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Biological and medical sciences ; Cefazolin - economics ; Cefazolin - therapeutic use ; Cephalosporins - economics ; Cephalosporins - therapeutic use ; Clinical Protocols ; Community-Acquired Infections - diagnosis ; Community-Acquired Infections - drug therapy ; Community-Acquired Infections - economics ; Community-Acquired Infections - mortality ; Cost-Benefit Analysis ; Drug Costs ; Drug Therapy, Combination ; Erythromycin - economics ; Erythromycin - therapeutic use ; Female ; Hospital Mortality ; Humans ; Injections, Intravenous ; Male ; Medical sciences ; Middle Aged ; New South Wales ; Penicillin G - economics ; Penicillin G - therapeutic use ; Penicillins - economics ; Penicillins - therapeutic use ; Pharmacology. Drug treatments ; Pneumonia - diagnosis ; Pneumonia - drug therapy ; Pneumonia - economics ; Pneumonia - mortality ; Prognosis ; Retrospective Studies ; Statistics, Nonparametric ; Treatment Outcome</subject><ispartof>Medical journal of Australia, 2001-04, Vol.174 (7), p.333-337</ispartof><rights>2001 AMPCo Pty Ltd. All rights reserved</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4327-695b569a67e9d0b73457da939ae90eef6ecaa7b58d2ee0b508cde9c81a53fcdc3</citedby><cites>FETCH-LOGICAL-c4327-695b569a67e9d0b73457da939ae90eef6ecaa7b58d2ee0b508cde9c81a53fcdc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=989672$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11346105$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dobbin, Catherine J</creatorcontrib><creatorcontrib>Duggan, Christopher J</creatorcontrib><creatorcontrib>Barnes, David J</creatorcontrib><title>The efficacy of an antibiotic protocol for community‐acquired pneumonia</title><title>Medical journal of Australia</title><addtitle>Med J Aust</addtitle><description>ABSTRACT
Objective
To assess the efficacy of an antibiotic protocol to avoid empirical use of third‐generation cephalosporins in community‐acquired pneumonia (CAP).
Design and setting
Retrospective case review of patients with CAP one year after implementing the protocol. Comparison was made with patients with CAP treated at a metropolitan tertiary referral hospital (where use of third‐generation cephalosporins was common).
Participants
86 patients (district hospital with an antibiotic protocol) and 72 patients (metropolitan tertiary referral hospital). January – June 1999.
Outcome measures
Rate of staff adherence to the protocol; patient characteristics associated with poor protocol adherence; demographic and prognostic features of both groups at presentation; duration of intravenous therapy, time to defervescence, length of stay; inpatient mortality rates; and drug cost savings per patient treated according to the protocol.
Results
Overall protocol adherence rate was 60%. Patients with penicillin allergy were significantly less likely to receive treatment according to the protocol (P<0.001). At the district hospital, patients were generally older and taking more regular medications, Patients at each hospital had similar prognostic factors and demographic features at presentation. Inhospital mortality (P=0.92; 95% CI, ‐0.08 to 0.07), duration of fever (P=0.57) and length of stay (P=0.78) were not significantly different between patients treated empirically with penicillin and those treated empirically with third‐generation cephalosporins. Treating a patient according to the protocol saved an average of $77.44 in drug costs.
Conclusion
One year after implementation, our protocol for treating CAP is proving efficacious, although levels of adherence could improve.</description><subject>Adult</subject><subject>Aged</subject><subject>Ampicillin - economics</subject><subject>Ampicillin - therapeutic use</subject><subject>Anti-Bacterial Agents - economics</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibacterial agents</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Biological and medical sciences</subject><subject>Cefazolin - economics</subject><subject>Cefazolin - therapeutic use</subject><subject>Cephalosporins - economics</subject><subject>Cephalosporins - therapeutic use</subject><subject>Clinical Protocols</subject><subject>Community-Acquired Infections - diagnosis</subject><subject>Community-Acquired Infections - drug therapy</subject><subject>Community-Acquired Infections - economics</subject><subject>Community-Acquired Infections - mortality</subject><subject>Cost-Benefit Analysis</subject><subject>Drug Costs</subject><subject>Drug Therapy, Combination</subject><subject>Erythromycin - economics</subject><subject>Erythromycin - therapeutic use</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Injections, Intravenous</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>New South Wales</subject><subject>Penicillin G - economics</subject><subject>Penicillin G - therapeutic use</subject><subject>Penicillins - economics</subject><subject>Penicillins - therapeutic use</subject><subject>Pharmacology. Drug treatments</subject><subject>Pneumonia - diagnosis</subject><subject>Pneumonia - drug therapy</subject><subject>Pneumonia - economics</subject><subject>Pneumonia - mortality</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Statistics, Nonparametric</subject><subject>Treatment Outcome</subject><issn>0025-729X</issn><issn>1326-5377</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNqVkMtKxDAUhoMoOl5eQQqCu9ZcmqbB1Th4RXEzgruQpieYoW1mmhZndj6Cz-iT2GFGXQuBcDjfyfnzIXRGcMIzmV7MEsJoFnMmREIxJklXkJQxLJLlDhr99nbRCGPKY0Hl6wE6DGE2lIRTsY8OCGFpRjAfofvpG0RgrTParCJvI90Mp3OF850z0bz1nTe-iqxvI-Prum9ct_r6-NRm0bsWymjeQF_7xuljtGd1FeBkex-hl5vr6eQufny-vZ-MH2OTMiriTPJi-IbOBMgSF4KlXJRaMqlBYgCbgdFaFDwvKQAuOM5NCdLkRHNmTWnYETrfvDtkW_QQOlW7YKCqdAO-D0rgnGVM5AN4uQFN60Nowap562rdrhTBam1SzdTallrbUmuT6sekWg7Tp9s1fVFD-Te7VTcAZ1tAB6Mr2-rGuPDLyVxmgg7U9YZ6dxWs_pNAPT2M6fRqU7JvXuOUJA</recordid><startdate>20010402</startdate><enddate>20010402</enddate><creator>Dobbin, Catherine J</creator><creator>Duggan, Christopher J</creator><creator>Barnes, David J</creator><general>Australasian Medical Publishing Company</general><scope>IQODW</scope><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>7X8</scope></search><sort><creationdate>20010402</creationdate><title>The efficacy of an antibiotic protocol for community‐acquired pneumonia</title><author>Dobbin, Catherine J ; Duggan, Christopher J ; Barnes, David J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4327-695b569a67e9d0b73457da939ae90eef6ecaa7b58d2ee0b508cde9c81a53fcdc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Ampicillin - economics</topic><topic>Ampicillin - therapeutic use</topic><topic>Anti-Bacterial Agents - economics</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibacterial agents</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Biological and medical sciences</topic><topic>Cefazolin - economics</topic><topic>Cefazolin - therapeutic use</topic><topic>Cephalosporins - economics</topic><topic>Cephalosporins - therapeutic use</topic><topic>Clinical Protocols</topic><topic>Community-Acquired Infections - diagnosis</topic><topic>Community-Acquired Infections - drug therapy</topic><topic>Community-Acquired Infections - economics</topic><topic>Community-Acquired Infections - mortality</topic><topic>Cost-Benefit Analysis</topic><topic>Drug Costs</topic><topic>Drug Therapy, Combination</topic><topic>Erythromycin - economics</topic><topic>Erythromycin - therapeutic use</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Injections, Intravenous</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>New South Wales</topic><topic>Penicillin G - economics</topic><topic>Penicillin G - therapeutic use</topic><topic>Penicillins - economics</topic><topic>Penicillins - therapeutic use</topic><topic>Pharmacology. Drug treatments</topic><topic>Pneumonia - diagnosis</topic><topic>Pneumonia - drug therapy</topic><topic>Pneumonia - economics</topic><topic>Pneumonia - mortality</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Statistics, Nonparametric</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dobbin, Catherine J</creatorcontrib><creatorcontrib>Duggan, Christopher J</creatorcontrib><creatorcontrib>Barnes, David J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medical journal of Australia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dobbin, Catherine J</au><au>Duggan, Christopher J</au><au>Barnes, David J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The efficacy of an antibiotic protocol for community‐acquired pneumonia</atitle><jtitle>Medical journal of Australia</jtitle><addtitle>Med J Aust</addtitle><date>2001-04-02</date><risdate>2001</risdate><volume>174</volume><issue>7</issue><spage>333</spage><epage>337</epage><pages>333-337</pages><issn>0025-729X</issn><eissn>1326-5377</eissn><coden>MJAUAJ</coden><abstract>ABSTRACT
Objective
To assess the efficacy of an antibiotic protocol to avoid empirical use of third‐generation cephalosporins in community‐acquired pneumonia (CAP).
Design and setting
Retrospective case review of patients with CAP one year after implementing the protocol. Comparison was made with patients with CAP treated at a metropolitan tertiary referral hospital (where use of third‐generation cephalosporins was common).
Participants
86 patients (district hospital with an antibiotic protocol) and 72 patients (metropolitan tertiary referral hospital). January – June 1999.
Outcome measures
Rate of staff adherence to the protocol; patient characteristics associated with poor protocol adherence; demographic and prognostic features of both groups at presentation; duration of intravenous therapy, time to defervescence, length of stay; inpatient mortality rates; and drug cost savings per patient treated according to the protocol.
Results
Overall protocol adherence rate was 60%. Patients with penicillin allergy were significantly less likely to receive treatment according to the protocol (P<0.001). At the district hospital, patients were generally older and taking more regular medications, Patients at each hospital had similar prognostic factors and demographic features at presentation. Inhospital mortality (P=0.92; 95% CI, ‐0.08 to 0.07), duration of fever (P=0.57) and length of stay (P=0.78) were not significantly different between patients treated empirically with penicillin and those treated empirically with third‐generation cephalosporins. Treating a patient according to the protocol saved an average of $77.44 in drug costs.
Conclusion
One year after implementation, our protocol for treating CAP is proving efficacious, although levels of adherence could improve.</abstract><cop>Sydney</cop><pub>Australasian Medical Publishing Company</pub><pmid>11346105</pmid><doi>10.5694/j.1326-5377.2001.tb143307.x</doi><tpages>5</tpages></addata></record> |
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| ispartof | Medical journal of Australia, 2001-04, Vol.174 (7), p.333-337 |
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| language | eng |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Adult Aged Ampicillin - economics Ampicillin - therapeutic use Anti-Bacterial Agents - economics Anti-Bacterial Agents - therapeutic use Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Cefazolin - economics Cefazolin - therapeutic use Cephalosporins - economics Cephalosporins - therapeutic use Clinical Protocols Community-Acquired Infections - diagnosis Community-Acquired Infections - drug therapy Community-Acquired Infections - economics Community-Acquired Infections - mortality Cost-Benefit Analysis Drug Costs Drug Therapy, Combination Erythromycin - economics Erythromycin - therapeutic use Female Hospital Mortality Humans Injections, Intravenous Male Medical sciences Middle Aged New South Wales Penicillin G - economics Penicillin G - therapeutic use Penicillins - economics Penicillins - therapeutic use Pharmacology. Drug treatments Pneumonia - diagnosis Pneumonia - drug therapy Pneumonia - economics Pneumonia - mortality Prognosis Retrospective Studies Statistics, Nonparametric Treatment Outcome |
| title | The efficacy of an antibiotic protocol for community‐acquired pneumonia |
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