title: Time to first antibiotic and mortality in adults hospitalised with community-acquired pneumonia: a matched-propensity analysis.
abstract: A matched-propensity analysis of national data from the British Thoracic Society community-acquired pneumonia audit was conducted (n=13 725). Overall, time to first antibiotic (TFA) was ≤4 h in 63%. Adjusted 30-day inpatient (IP) mortality was lower for adults with TFA ≤4 h compared with TFA >4 h (adjusted OR 0.84, 95% CI 0.74 to 0.94; p=0.003). Increasing TFA was associated with greater OR of 30-day IP mortality (p value for trend=0.001), but no TFA threshold was evident. Although we found an association between TFA and mortality, we cannot say whether this is causal or whether TFA might just be a quality measure for overall or other processes of care.
authors.affiliation: Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Priya
authors.initials: P
authors.lastname: Daniel
authors.affiliation: Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Chamira
authors.initials: C
authors.lastname: Rodrigo
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
authors.forename: Tricia M
authors.initials: TM
authors.lastname: Mckeever
authors.affiliation: Department of Respiratory Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Woodhead
authors.affiliation: British Thoracic Society, London, UK.
authors.forename: Sally
authors.initials: S
authors.lastname: Welham
authors.affiliation: Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Wei Shen
authors.initials: WS
authors.lastname: Lim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000401:mortality; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy* / Q000401:mortality; D057216:Propensity Score; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014852:Wales / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Pneumonia