Compliance with Practice Guideline for Prescribing Antibiotics for Community-Acquired Bacterial Pneumonia in Outpatient Department
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Abstract
Objective: To examine consistency of antibiotic use with the treatment guideline for community-acquired bacterial pneumonia (CAP) at outpatient department of Kranuan Crown Prince Hospital, Khon Kaen. Methods: The study design was retrospective descriptive study. Outpatient medical records with CAP between January 1, 2017 and December 31, 2019 were reviewed. The study assessed consistency of antibiotic prescribing against that in treatment guideline for CAP of the American Thoracic Society/Infectious Diseases Society of America in 2019 (ATS/IDSA 2019). Results: Number of eligible subjects was 304. Treatment in 45.1%of patients conformed to treatment guideline in all aspects including drug, dosage and duration of administration. Treatment in 46.7% of patients were inconsistent with the guideline in one aspect, those in 2.6% were inconsistent with the guideline in all aspects. Among 287 patients receiving antibiotics, 223 of them (77.7%) were prescribed types of antibiotics consistent to the guideline. 97.3, 93.6 and 79.8% of patients with no comorbidities were prescribed antibiotics consistent to the guideline in terms of drugs, dosage and duration, respectively. Only 14.7% of patients with comorbidities were prescribed antibiotics consistent to the guideline in terms of drugs.Conclusion: Percentage of antibiotic prescribing for CAP in outpatient department consistent with the treatment guideline in all aspects (drug, dosage and duration of administration) was less than 50%.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
World Health Organization. The top 10 causes of death [online]. 2018 [cited Dec 31, 2018]. Available from: www.who.int/news-room/fact-sheets/detail/th e-top-10-causes-of-death.
Bureau of epidemiology. Annual epidemiological surveillance report 2017 [online]. 2018 [cited Nov 11, 2018]. Available from: 203.157.15.110/boeeng/ annual.php.
Ministry of Public Health. The top 10 diseases in the inpatient department [online] 2019 [cited Apr 30, 2020]. Available from:hdcservice.moph.go.th/hdc/re ports/report.php?source=pformated/format2.php&cat_id=491672679818600345dc1833920051b2&id=87af734bc7575ecba528b7c9dba063bb.
Lopardo GD, Fridman D, Raimondo E, Albornoz H, Lopardo A, Bagnulo H, et al. Incidence rate of community-acquired pneumonia in adults: a popu lation based prospective active surveillance study in three cities in South America. BMJ 2018; 8: 1-9.
Personnea V, Chevalier J, Buffel C, Partouchea H, Gilberga S, Pouvourville G. CAPECO: Cost evaluation of community acquired pneumonia managed in primary care. Vaccine 2016; 34: 2275–80.
Divinoa V, Schranzb J, Earlyc M, Shahd H, Jianga M, DeKovena M. The annual economic burden among patients hospitalized for community acquired pneumonia (CAP): a retrospective US cohort study. Curr Med Res Opin 2020; 36: 151–60.
Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious diseases society of America/American Thoracic Society Con sensus Guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007; 44: 27-72.
Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and treatment of adults with community-acquired pneumonia: An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019; 200: 45-67.
Pediatric Pulmonary & Critical Care Thai Society. Diagnosis and treatment of children with acute respiratory tract infections [online]. 2019 [cited Apr 30, 2020]. Available from: www.thaipediatrics. org/Media/media-20190906151602.pdf.
Wattengel BA, Sellick JA, Skelly MK, Napierala R, Schroeck J, Mergenhagen KA. Outpatient antimicro bial stewardship: targets for community-acquired pneumonia. Clin Ther 2019; 41: 466-76.
Micek ST, Lang A, Fuller BM, Hampton NB, Kollef MH. Clinical implications for patients treated inappropriately for community-acquired pneumonia in the emergency department. BMC Infect Dis 2014; 14: 1-8.
Wongsurakiat P, Chitwarakorn N. Severe community-acquired pneumonia in general medical wards: outcomes and impact of initial antibiotic selection. BMC Pulm Med 2019; 19: 2-10.
Tansarli GS, Mylonakisa E. Systematic review and meta-analysis of the efficacy of short course antibiotic treatments for community-acquired pneu monia in adults. Antimicrob Agents Chemother 2018; 62: 1-13.
