Management of patients with community-acquired pneumonia treated in hospital in Sweden.
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.
Hedlund
Jonas
J
Department of Infectious Diseases, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden. jonas.hedlund@ks.se
Ortqvist
Ake
A
Ahlqvist
Thomas
T
Augustinsson
Asa
A
Beckman
Hans
H
Blanck
Charlotta
C
Burman
Lars A
LA
Claesson
Bo
B
Qvarfordt
Ingemar
I
Elbel
Elisabeth
E
Erntell
Mats
M
Follin
Per
P
Goscinski
Gunilla
G
Holmberg
Hans
H
Höfer
Margareta
M
Jorup
Christina
C
Lidman
Christer
C
Lindhusen
Eva
E
Rensfeldt
Gunilla
G
Rosenkvist
Elisabeth
E
Stenlund
Göran
G
Stålberg
Ake
A
Verngren
Karin
K
Vig
Ivan
I
Wendahl
Suzanne
S
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
D002511:Cephalosporins; D010406:Penicillins