title: Management of patients with community-acquired pneumonia treated in hospital in Sweden.
abstract: To investigate the management of patients with community-acquired pneumonia (CAP) treated in hospital in Sweden, a multicentre retrospective cohort study was performed with medical record review of 982 patients (mean age 63 y) at 17 departments of infectious diseases at hospitals in Sweden. Information on antimicrobial therapy, demographic characteristics, comorbid conditions, physical examination findings, and laboratory and microbiological test results were recorded. Outcome measures were in-hospital mortality and length of hospital stay (LOS). Cultures were obtained from blood in 80% and from sputum in 22% of the patients. A microbiological aetiology was determined for 23% of the patients, with Streptococcus pneumoniae as the dominating agent (9%). The initial antibiotic treatment was mostly given intravenously (78%). Penicillin (50%) or a cephalosporin (30%) was the most common choice. Both of these drugs were usually given as a single agent. The overall mortality was 3.5% and the mean LOS was 6.4 d. Thus, the outcome was favourable despite the empirical antibiotic treatment having a narrow spectrum compared with the broader approach recommended in most recent guidelines on the management of CAP. These findings suggest that a majority of patients who are hospitalized with moderately severe pneumonia can be treated initially with penicillin alone.
authors.affiliation: Department of Infectious Diseases, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden. jonas.hedlund@ks.se
authors.forename: Jonas
authors.initials: J
authors.lastname: Hedlund
authors.forename: Ake
authors.initials: A
authors.lastname: Ortqvist
authors.forename: Thomas
authors.initials: T
authors.lastname: Ahlqvist
authors.forename: Asa
authors.initials: A
authors.lastname: Augustinsson
authors.forename: Hans
authors.initials: H
authors.lastname: Beckman
authors.forename: Charlotta
authors.initials: C
authors.lastname: Blanck
authors.forename: Lars A
authors.initials: LA
authors.lastname: Burman
authors.forename: Bo
authors.initials: B
authors.lastname: Claesson
authors.forename: Ingemar
authors.initials: I
authors.lastname: Qvarfordt
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Elbel
authors.forename: Mats
authors.initials: M
authors.lastname: Erntell
authors.forename: Per
authors.initials: P
authors.lastname: Follin
authors.forename: Gunilla
authors.initials: G
authors.lastname: Goscinski
authors.forename: Hans
authors.initials: H
authors.lastname: Holmberg
authors.forename: Margareta
authors.initials: M
authors.lastname: Höfer
authors.forename: Christina
authors.initials: C
authors.lastname: Jorup
authors.forename: Christer
authors.initials: C
authors.lastname: Lidman
authors.forename: Eva
authors.initials: E
authors.lastname: Lindhusen
authors.forename: Gunilla
authors.initials: G
authors.lastname: Rensfeldt
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Rosenkvist
authors.forename: Göran
authors.initials: G
authors.lastname: Stenlund
authors.forename: Ake
authors.initials: A
authors.lastname: Stålberg
authors.forename: Karin
authors.initials: K
authors.lastname: Verngren
authors.forename: Ivan
authors.initials: I
authors.lastname: Vig
authors.forename: Suzanne
authors.initials: S
authors.lastname: Wendahl
mesh_terms: D000293:Adolescent; D000368:Aged; D002511:Cephalosporins / Q000627:therapeutic use; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006760:Hospitalization; D006801:Humans; D008297:Male; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification; D010406:Penicillins / Q000627:therapeutic use; D011014:Pneumonia / Q000188:drug therapy* / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D013548:Sweden; D016896:Treatment Outcome
chemical_list: D002511:Cephalosporins; D010406:Penicillins