title: Administration of first hospital antibiotics for community-acquired pneumonia: does timeliness affect outcomes?
abstract: OBJECTIVE
  Associations between processes of care for hospitalized community-acquired pneumonia patients and clinical outcomes are important because of the high incidence of such admissions and substantial related mortality. Several studies have examined these associations.
  
  
  RESULTS
  Large retrospective studies of older patients have demonstrated associations between time to first dose as short as 4 h and length of stay and mortality during and after hospitalization. Results of smaller studies have been less consistent. The association appears to be strongest among older patients who have not received antibiotics prior to arrival at the hospital.
  
  
  CONCLUSIONS
  A significant and causal relationship appears to exist between antibiotic timing and improved outcomes, especially among older patients. Even modest improvements in timeliness of antibiotic administration could impact a substantial number of lives because of the high incidence of community-acquired pneumonia hospitalization.
authors.affiliation: Centers for Medicare and Medicaid Services, Seattle, Washington, USA. phouck@cdc.gov
authors.forename: Peter M
authors.initials: PM
authors.lastname: Houck
authors.forename: Dale W
authors.initials: DW
authors.lastname: Bratzler
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000401:mortality; D004334:Drug Administration Schedule; D006801:Humans; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents