title: Adherence with national guidelines in hospitalized patients with community-acquired pneumonia: results from the CAPO study in Venezuela.
abstract: BACKGROUND
  The Community-Acquired Pneumonia Organization (CAPO) is an international observational study in 130 hospitals, with a total of 31 countries, to assess the current management of hospitalized patients with community-acquired pneumonia (CAP). 2 Using the centralized database of CAPO was decided to conduct this study with the aim of evaluate the level of adherence with national guidelines in Venezuela, to define in which areas an intervention may be necessary to improve the quality of care of hospitalized patients with CAP.
  
  
  METHODS
  In this observational retrospective study quality indicators were used to evaluate the management of hospitalized patients with CAP in 8 Venezuelan's centers. The care of the patients was evaluated in the areas of: hospitalization, oxygen therapy, empiric antibiotic therapy, switch therapy, etiological studies, blood cultures indication, and prevention. The compliance was rated as good (>90%), intermediate (60% to 90%), or low (<60%).
  
  
  RESULTS
  A total of 454 patients with CAP were enrolled. The empiric treatment administered within 8 hours of the patient arrival to the hospital was good (96%), but the rest of the indicators showed a low level of adherence (<60%).
  
  
  CONCLUSIONS
  We can say that there are many areas in the management of CAP in Venezuela that are not performed according to the national guidelines of SOVETHORAX.1 In any quality improvement process the first step is to evaluate the difference between what is recommended and what is done in clinical practice. While this study meets this first step, the challenge for the future is to implement the processes necessary to improve the management of CAP in Venezuela.
authors.affiliation: Servicio de Neumología, Hospital Universitario de Caracas, Caracas, Venezuela.
authors.forename: Gur
authors.initials: G
authors.lastname: Levy
authors.affiliation: Servicio de Neumología, Hospital Universitario de los Andes, Mérida, Venezuela.
authors.forename: Mario
authors.initials: M
authors.lastname: Perez
authors.affiliation: Servicio de Medicina Interna, Hospital IVSS Dr. Domingo Guzmán L. Barcelona, Estado Anzoátegui, Venezuela.
authors.forename: Benito
authors.initials: B
authors.lastname: Rodríguez
authors.affiliation: Servicio de Medicina Interna, Hospital IVSS Dr. Domingo Guzmán L. Barcelona, Estado Anzoátegui, Venezuela.
authors.forename: Ana
authors.initials: A
authors.lastname: Hernández Voth
authors.affiliation: División de Enfermedades Infecciosas, Universidad de Louisville, Kentucky, Estados Unidos.
authors.forename: Jorge
authors.initials: J
authors.lastname: Perez
authors.affiliation: División de Enfermedades Infecciosas, Universidad de Louisville, Kentucky, Estados Unidos.
authors.forename: Martin
authors.initials: M
authors.lastname: Gnoni
authors.affiliation: División de Enfermedades Infecciosas, Universidad de Louisville, Kentucky, Estados Unidos.
authors.forename: Robert
authors.initials: R
authors.lastname: Kelley
authors.affiliation: División de Enfermedades Infecciosas, Universidad de Louisville, Kentucky, Estados Unidos.
authors.forename: Timothy
authors.initials: T
authors.lastname: Wiemken
authors.affiliation: División de Enfermedades Infecciosas, Universidad de Louisville, Kentucky, Estados Unidos. Electronic address: julio.ramirez@louisville.edu.
authors.forename: Julio
authors.initials: J
authors.lastname: Ramirez
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001769:Blood / Q000382:microbiology; D017714:Community-Acquired Infections / Q000097:blood / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D057915:Drug Substitution; D004363:Drug Utilization; D005260:Female; D019983:Guideline Adherence; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007262:Infusions, Intravenous; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D016540:Smoking Cessation; D014687:Venezuela
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clinical practice guidelines; Guías de práctica cínica; Health care quality indicators; Indicadores de calidad de la atención de salud; Neumonía; Pneumonia