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Abstract：
BACKGROUND: Very few data exist on the management of community-acquired pneumonia (CAP) in patients admitted to hospitals in the Gulf region. The objectives of this study were to describe treatment patterns for CAP in 38 hospitals in five Gulf countries (United Arab Emirates, Kuwait, Bahrain, Oman, and Qatar) and to compare the findings to the most recent Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) guidelines.
METHODS: This was a prospective, observational study conducted between January 2009 and February 2011. Adult patients hospitalised (excluding intensive care units) for CAP and subsequently discharged were included. Data were collected retrospectively at hospital discharge, and prospectively during two follow-up visits. Data on medical history, mortality-risk scores, diagnostic criteria, antibiotic treatment, isolated pathogens and clinical and radiographic outcomes were collected. Care practices were compared to the IDSA/ATS guidelines.
RESULTS: A total of 684 patients were included. The majority (82.9 %) of patients were classified as low risk for mortality (pneumonia severity index II and III). The majority of patients fulfilled criteria for treatment success at discharge, although only 77.6 % presented a normalised leukocyte count. Overall, the management of CAP in Gulf countries is in line with the IDSA/ATS guidelines. This applied to the diagnosis of CAP, to the identification of high-risk CAP patients, to the identification of etiologic agent responsible for CAP and to the type of treatment despite the fact that combinations of antimicrobial agents were not consistent with the guidelines in 10 % of patients. In all patients, information about Gram\'s staining was not captured as recommended by the IDSA/ATS and in the majority of patients (>85 %) chest radiography was not systematically performed at the post-discharge follow-up visits.
CONCLUSIONS: The management of CAP in the Gulf region is globally in line with current IDSA/ATS guidelines, although rates of pathogen characterisation and post-discharge follow-up need to be improved.
CONCLUSIONS: Compliance with established guidelines should be encouraged in order to improve the management of the disease in this region.
METHODS: This was a prospective, observational study conducted between January 2009 and February 2011. Adult patients hospitalised (excluding intensive care units) for CAP and subsequently discharged were included. Data were collected retrospectively at hospital discharge, and prospectively during two follow-up visits. Data on medical history, mortality-risk scores, diagnostic criteria, antibiotic treatment, isolated pathogens and clinical and radiographic outcomes were collected. Care practices were compared to the IDSA/ATS guidelines.
RESULTS: A total of 684 patients were included. The majority (82.9 %) of patients were classified as low risk for mortality (pneumonia severity index II and III). The majority of patients fulfilled criteria for treatment success at discharge, although only 77.6 % presented a normalised leukocyte count. Overall, the management of CAP in Gulf countries is in line with the IDSA/ATS guidelines. This applied to the diagnosis of CAP, to the identification of high-risk CAP patients, to the identification of etiologic agent responsible for CAP and to the type of treatment despite the fact that combinations of antimicrobial agents were not consistent with the guidelines in 10 % of patients. In all patients, information about Gram\'s staining was not captured as recommended by the IDSA/ATS and in the majority of patients (>85 %) chest radiography was not systematically performed at the post-discharge follow-up visits.
CONCLUSIONS: The management of CAP in the Gulf region is globally in line with current IDSA/ATS guidelines, although rates of pathogen characterisation and post-discharge follow-up need to be improved.
CONCLUSIONS: Compliance with established guidelines should be encouraged in order to improve the management of the disease in this region.
摘要：
背景：关于海湾地区住院患者社区获得性肺炎（CAP）管理的数据很少。本研究的目的是描述五个海湾国家38家医院的CAP治疗模式(阿拉伯联合酋长国，科威特,巴林,阿曼,和卡塔尔），并将研究结果与最新的美国传染病学会（IDSA）/美国胸科学会（ATS）指南进行比较。
方法：这是一个前瞻性的，2009年1月至2011年2月进行的观察性研究.包括因CAP住院（不包括重症监护病房）并随后出院的成年患者。数据是在出院时回顾性收集的，以及在两次后续访问中的预期。病史资料,死亡率-风险评分，诊断标准,抗生素治疗,收集分离的病原体以及临床和影像学结果.将护理实践与IDSA/ATS指南进行了比较。
结果：共纳入684例患者。大多数（82.9％）的患者被归类为低死亡风险（肺炎严重程度指数II和III）。大多数患者在出院时符合治疗成功的标准，尽管只有77.6%的白细胞计数恢复正常。总的来说,海湾国家CAP的管理符合IDSA/ATS指南。这适用于CAP的诊断，识别高危CAP患者，尽管在10%的患者中,抗菌药物的组合与指南不一致,但导致CAP的病原体的鉴定和治疗类型.在所有患者中，未按照IDSA/ATS的建议收集有关革兰氏染色的信息,在大多数患者(>85%)中,在出院后随访访视时未进行系统的胸片检查.
结论：海湾地区的CAP管理在全球范围内符合当前的IDSA/ATS指南，尽管病原体特征和出院后随访率有待提高。
结论：应鼓励遵守既定指南，以改善该地区的疾病管理。
方法：这是一个前瞻性的，2009年1月至2011年2月进行的观察性研究.包括因CAP住院（不包括重症监护病房）并随后出院的成年患者。数据是在出院时回顾性收集的，以及在两次后续访问中的预期。病史资料,死亡率-风险评分，诊断标准,抗生素治疗,收集分离的病原体以及临床和影像学结果.将护理实践与IDSA/ATS指南进行了比较。
结果：共纳入684例患者。大多数（82.9％）的患者被归类为低死亡风险（肺炎严重程度指数II和III）。大多数患者在出院时符合治疗成功的标准，尽管只有77.6%的白细胞计数恢复正常。总的来说,海湾国家CAP的管理符合IDSA/ATS指南。这适用于CAP的诊断，识别高危CAP患者，尽管在10%的患者中,抗菌药物的组合与指南不一致,但导致CAP的病原体的鉴定和治疗类型.在所有患者中，未按照IDSA/ATS的建议收集有关革兰氏染色的信息,在大多数患者(>85%)中,在出院后随访访视时未进行系统的胸片检查.
结论：海湾地区的CAP管理在全球范围内符合当前的IDSA/ATS指南，尽管病原体特征和出院后随访率有待提高。
结论：应鼓励遵守既定指南，以改善该地区的疾病管理。
