title: Time to first antibiotic dose for patients hospitalised with community-acquired pneumonia.
abstract: Time to first antibiotic dose (TFAD) of 4h or 8h has been suggested as a quality measure for adult patients hospitalised with community-acquired pneumonia (CAP). Clinical evidence leading to implementation of this quality measure came from two large, retrospective studies. Following these studies, several prospective studies were conducted, with variable results. In a compilation of all observational studies to date, no significant benefit for short TFAD in terms of all-cause mortality was observed [unadjusted odds ratio (OR) = 1.01, 95% confidence interval (CI) 0.79-1.29, 13 studies; adjusted OR = 0.95, 95% CI 0.73-1.23, 14 studies]. Implementation of a requirement for short TFAD for CAP in the emergency department or other acute medical care setting may lead to unnecessary antibiotic treatment. We believe that attention should be shifted to early appropriate empirical antibiotic treatment for severe sepsis in hospital regardless of the source of infection, rather than focusing on CAP.
authors: Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah-Tiqva, Israel. dafna.yahav@gmail.com
authors: Dafna
authors: D
authors: Yahav
authors: Leonard
authors: L
authors: Leibovici
authors: Elad
authors: E
authors: Goldberg
authors: Jihad
authors: J
authors: Bishara
authors: Mical
authors: M
authors: Paul
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents