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Abstract：
BACKGROUND: Many factors determine empirical antibiotic treatment of community-acquired pneumonia (CAP). We aimed to describe the empirical antibiotic treatment CAP patients with an acute hospital visit and to determine if the current treatment algorithm provided specific and sufficient coverage against Legionella pneumophila, Mycoplasma pneumoniae, and Clamydophila pneumoniae (LMC).
METHODS: A descriptive cross-sectional, multicenter study of all adults with an acute hospital visit in the Region of Southern Denmark between January 2016 and March 2018 was performed. Using medical records, we retrospectively identified the empirical antibiotic treatment and the microbiological etiology for CAP patients. CAP patients who were prescribed antibiotics within 24 h of admission and with an identified bacterial pathogen were included. The prescribed empirical antibiotic treatment and its ability to provide specific and sufficient coverage against LMC pneumonia were determined.
RESULTS: Of the 19,133 patients diagnosed with CAP, 1590 (8.3%) patients were included in this study. Piperacillin-tazobactam and Beta-lactamase sensitive penicillins were the most commonly prescribed empirical treatments, 515 (32%) and 388 (24%), respectively. Our analysis showed that 42 (37%, 95% CI: 28-47%) of 113 patients with LMC pneumonia were prescribed antibiotics with LMC coverage, and 42 (12%, 95% CI: 8-15%) of 364 patients prescribed antibiotics with LMC coverage had LMC pneumonia.
CONCLUSIONS: Piperacillin-tazobactam, a broad-spectrum antibiotic recommended for uncertain infectious focus, was the most frequent CAP treatment and prescribed to every third patient. In addition, the current empirical antibiotic treatment accuracy was low for LMC pneumonia. Therefore, future research should focus on faster diagnostic tools for identifying the infection focus and precise microbiological testing.
METHODS: A descriptive cross-sectional, multicenter study of all adults with an acute hospital visit in the Region of Southern Denmark between January 2016 and March 2018 was performed. Using medical records, we retrospectively identified the empirical antibiotic treatment and the microbiological etiology for CAP patients. CAP patients who were prescribed antibiotics within 24 h of admission and with an identified bacterial pathogen were included. The prescribed empirical antibiotic treatment and its ability to provide specific and sufficient coverage against LMC pneumonia were determined.
RESULTS: Of the 19,133 patients diagnosed with CAP, 1590 (8.3%) patients were included in this study. Piperacillin-tazobactam and Beta-lactamase sensitive penicillins were the most commonly prescribed empirical treatments, 515 (32%) and 388 (24%), respectively. Our analysis showed that 42 (37%, 95% CI: 28-47%) of 113 patients with LMC pneumonia were prescribed antibiotics with LMC coverage, and 42 (12%, 95% CI: 8-15%) of 364 patients prescribed antibiotics with LMC coverage had LMC pneumonia.
CONCLUSIONS: Piperacillin-tazobactam, a broad-spectrum antibiotic recommended for uncertain infectious focus, was the most frequent CAP treatment and prescribed to every third patient. In addition, the current empirical antibiotic treatment accuracy was low for LMC pneumonia. Therefore, future research should focus on faster diagnostic tools for identifying the infection focus and precise microbiological testing.
摘要：
背景：许多因素决定了社区获得性肺炎（CAP）的经验性抗生素治疗。我们旨在描述急性住院的经验抗生素治疗CAP患者，并确定当前的治疗算法是否提供了针对肺炎军团菌的特定和足够的覆盖范围。肺炎支原体,和肺炎嗜铬杆菌(LMC)。
方法：描述性横截面，对2016年1月至2018年3月在丹麦南部地区进行急性住院就诊的所有成人进行多中心研究.利用医疗记录，我们回顾性确定了CAP患者的经验性抗生素治疗和微生物学病因.包括在入院后24小时内使用抗生素并具有确定的细菌病原体的CAP患者。确定了规定的经验性抗生素治疗及其提供针对LMC肺炎的特定和足够覆盖范围的能力。
结果：在诊断为CAP的19,133例患者中，1590例(8.3%)患者纳入本研究。哌拉西林-他唑巴坦和β-内酰胺酶敏感性青霉素是最常用的经验性治疗方法，515（32%）和388（24%），分别。我们的分析表明，42(37%，95％CI：28-47％）113例LMC肺炎患者中开了LMC覆盖的抗生素，和42(12%，95％CI：8-15％）的364例LMC覆盖的抗生素患者患有LMC肺炎。
结论：哌拉西林他唑巴坦，一种广谱抗生素，推荐用于不确定的感染病灶，是最常见的CAP治疗，每三分之一的患者都有处方。此外,对于LMC肺炎,目前经验性抗生素治疗的准确性较低.因此,未来的研究应该集中在更快的诊断工具上，以确定感染重点和精确的微生物检测。
方法：描述性横截面，对2016年1月至2018年3月在丹麦南部地区进行急性住院就诊的所有成人进行多中心研究.利用医疗记录，我们回顾性确定了CAP患者的经验性抗生素治疗和微生物学病因.包括在入院后24小时内使用抗生素并具有确定的细菌病原体的CAP患者。确定了规定的经验性抗生素治疗及其提供针对LMC肺炎的特定和足够覆盖范围的能力。
结果：在诊断为CAP的19,133例患者中，1590例(8.3%)患者纳入本研究。哌拉西林-他唑巴坦和β-内酰胺酶敏感性青霉素是最常用的经验性治疗方法，515（32%）和388（24%），分别。我们的分析表明，42(37%，95％CI：28-47％）113例LMC肺炎患者中开了LMC覆盖的抗生素，和42(12%，95％CI：8-15％）的364例LMC覆盖的抗生素患者患有LMC肺炎。
结论：哌拉西林他唑巴坦，一种广谱抗生素，推荐用于不确定的感染病灶，是最常见的CAP治疗，每三分之一的患者都有处方。此外,对于LMC肺炎,目前经验性抗生素治疗的准确性较低.因此,未来的研究应该集中在更快的诊断工具上，以确定感染重点和精确的微生物检测。
