[An analysis of the correlation between guidelines-concordant treatment and the treatment outcome on nursing and healthcare-associated pneumonia patients].
BACKGROUND
The nursing and healthcare-associated pneumonia (NHCAP) guidelines recommend broad-spectrum antibiotics usage when the presence of multidrug resistant pathogens is anticipated. However, it has not been proved that guidelines-concordant treatment improves the outcome.


OBJECTIVE
To clarify the impact of guidelines-concordant treatment on the outcome of NHCAP patients.


METHODS
This was a single-center, medical record based retrospective study. The outcomes of NHCAP patients who were treated with guidelines-concordant antibiotics were compared with those of the patients who were not so treated. Then, along with other parameters such as pneumonia severity or patient backgrounds, we analyzed what parameters affected the outcome of NHCAP.


RESULTS
Two hundred and twenty-six admissions were analyzed. Guidelines-concordant treatment did not show significant correlation with 30 days mortality, in-hospital mortality or treatment failure. A multivariate analysis showed a significant correlation between the treatment outcome and no parameters other than "Classified into severe-group of community-acquired pneumonia". Even in the analysis limited to the patients who were actually proved to possess drug-resistant pathogens, the antibiotic coverage of the pathogens did not show any correlation with the outcomes.


CONCLUSIONS
NHCAP guidelines-concordant treatment might not improve the patient outcome.
Department of Respiratory Medicine, Tenri Hospital.
Yoshinari
Y
Nakatsuka
Department of Respiratory Medicine, Tenri Hospital.
Chie
C
Morimoto
Department of Respiratory Medicine, Tenri Hospital.
Ikkoh
I
Yasuda
Department of Respiratory Medicine, Tenri Hospital.
Takahiro
T
Tsuji
Department of Respiratory Medicine, Tenri Hospital.
Yusuke
Y
Kaji
Department of Respiratory Medicine, Tenri Hospital.
Takehiro
T
Yasuda
Department of Respiratory Medicine, Tenri Hospital.
Seishu
S
Hashimoto
Department of Respiratory Medicine, Tenri Hospital.
Hwang Moon
HM
Hee
Department of Respiratory Medicine, Tenri Hospital.
Takashi
T
Hajiro
Department of Respiratory Medicine, Tenri Hospital.
Eisaku
E
Tanaka
Department of Respiratory Medicine, Tenri Hospital.
Yoshio
Y
Taguchi
D000368:Aged; D003428:Cross Infection / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000209:etiology / Q000451:nursing; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome